Functional Assessment Fall Assessment- 21.6 % percent of world population will be geriatrics by 2050. This is up from 12.2 % in 1950.
- 30% > 65 fall each year
- 5-10 % fall cause serous injury
- Hip Fracture if present increases mortality of > 20-30%
- Risk assessment
- Intrinsic
- Sarcopenia / Frailty (decreased muscle mass and strength)
- Impaired sensorium (vision, proprioception)
- Multiple morbidity
- Extrinsic
- Vitamin D deficiency
- House hazards
- Polypharmacy
- Evaluation
- Clinical Evaluaiton
- History
- Physical
- Vision, Cognition, Gait and Balance, Lowe limb joints, neurological
- Timed get up and go test
- Taking 14 sec or longer for 10 feet or 3 meters is associated with high risk for fall
- Medication Review
- Labs (as indicated)
- Complications
- Fractures and Injuries
- Decline in functional status
- Fear of falling
- Increased Mortality
- Obtain fall management algorithm fro Dr. Negrea's presentation
- 250 Million $ per year for checking Vitamin D level. Cost effectiveness of it compared to avoidance of complication? Will the diagnose of lab deficiency improve the compliance?
Frailty :- Definition: State of Increased Vulnerability to poor resolution of homeostasis after stressor event, which increases risk of adverse outcome (including Fall, Delirium, Disability)
- Pathophysiology: Reduced physiological reserve of Multiple Organ System along with decreased Physical Activity and Nutritional Status
- Frailty Model:
- 5 Phenotypical Model Indicators of Frailty
- Weight loss
- Self reported exhaustion
- Low energy expenditure
- Slow gait speed
- Weak grip strength
- Cumulative Deficit Model
Frality in elderly people Lancet 2013 |
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