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Geriatrics

DOC
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The Most Commonly Indicated Drugs to the Elderly

Key words: decubiti, emphysema, deconditioning, dementia, muskuloskeletal limitations, senile osteoporosis, diabetes, to perform self-care, activities of daily living, manual handling, proneness to falls, self-sufficiency

AGE-RELATED ISSUES

  1. Deconditioning

Aged persons have decreased strength, endurance and joint mobility. A 70-year-old man has approximately the same strength as a 15-year-old boy, but without the endurance or flexibility. Deconditioning becomes significant when it results in the old person being unable to perform self-care, carry out activities of daily living, or move about safely.

The decrease in physical activity and exercise that frequently accompanies aging may be

a major influence in the loss of strength and endurance. Benefits of a regular exercise programme can be both physical and psychological.

  1. Falls

Falling is a feared but common incident for elderly persons. Risk factors can be intrinsic,

activity-related, or environmental. Intrinsic factors are medical conditions that impair a person and predispose him or her to fall. Decreased balance, decreased strength, and decreased flexibility are all factors related to risk of falling. Older persons impaired because of a stroke or a lower-limb amputation are also in high risk categories. Acute illness and decreased alertness because of medication are the intrinsic factors that are always important to take into account.

Activity-related falls usually occur during routine daily activities. Falls frequently occur when elderly person leans or reaches from a wheelchair and when gets out of bed at night.

Finally, environmental factors increase the risk of a fall. Factors such as inadequate lighting, a slippery or rough floor surface, stairs, an inaccessible bathtub, and icy walkways are just a few of the items to be considered in a comprehensive risk assessment.

Prevention is always the best intervention. A home assessment by the therapist will allow appropriate placement of grab bars. The gait training is important.

  1. Urinary Incontinence

Urinary incontinence is a problem frequently encountered by older persons. It may be due to significant medical disease. It can affect an older person’s acceptance in the family and the community.

  1. Constipation

The cause for this problem is not necessarily ages itself but rather other factors, which include poor diet, inadequate fluid intake, too little physical exercise, and medications.

  1. Osteoporosis

Fractures secondary to osteoporosis are disabling because of the chronic severe pain caused by vertebral compression fractures and the loss of ability to walk following fracture of the hip. Senile osteoporosis constitutes a serious threat of fractures in women and men over the age of 75. Optimal treatment is prevention. The rehabilitation considerations for osteoporosis are: diet, exercise, physical therapy, orthotics, and endocrines.

  1. Dementia

Forgetfulness is a characteristic of aging, and fear of senile dementia commonly accompanies growing old. In fact, intellectual functions are relatively well maintained in normal aging. Some older persons may show mental impairment. They are more prone to have adverse drug reactions. When prescribing medication for an old person, it is important to first review drugs already prescribed.

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