% of people with no difficulty in self care actitivies

65-69: 80%

80-84: 66%

walking 1/4 mile

lifting 10 lbs

climbing 10 steps without resting

65-75

maintained a level of fitness that lets them participate in recreational and daily activity requirements

75-85

independent with daily activities but need help with more demanding tasks

older than 85

disabled patients that require nursing home care

OA

hypertension

hearing impairement

heart disease

orthopaedic deformity

chronic sinusitis

visual impairment

diabetes

varicose veins

abdominal hernia

heart disease

cancer 

stroke

arthritis

osteoporosis

paget's

fat pad syndrome

alzheimer's

parkinson's

multi infarct dementia

depression

normal pressure hydrocephalus

vision loss

hearing loss

tinnitus

chronic sinusitis

diabetes

hyperthyroid

hyperparathyroid

CHF

coronary artery disease

hypertension

stroke

AAA

temporal arteritis

chronic renal failure

incontence

breast cancer

ovarian cancer

prostate cancer

hiatal hernia

constipation

diverticulitis

colorectal cancer

focused hx

an exam

evaluate mental function

evaluate socioeconomic health

nutritional status

screening risks

non-fasting total blood cholesterol/ua/thyroid

electrocariogram

consider most common conditions in elderly

look at symptoms and determine if they're drug related

screen for cancer

perform comprehensive exam

emphasizing stability

pain reduction

maintain as much joint mobility as possible

heart disease

malignant neoplasm

cerebrovascular disease

COPD

pneumonia and influenza

blood pressure

heigh and weight

fecal occult blood test/sigmoidoscopy

mammogram (<69 or equal)

pap test

vision screening

hearing impairment

drinking problem

flat hand contact for anteriors

avoid excessive rotation techniques

avoid extreme spinal flexion

allow the head piece 

provide some distraction prior to thrusting for extremities

logan basic

cox traction

pelvic blocking: SOT

activator

protein deamidation

dna-cross linking

single-strand breakage

decrease DNA methylation

decrease DNA telometric sequence

current drug hx

dietary hx

hx of falling

hx of incontinence

questionnaires evaluation depression,anxiety, and mental functioning

bathing

dress/grooming

self-feeding

toileting

maintaining contience

mobility level

transferring

using telephone

preparing meals

performing work around the house

doing laundry

shopping

transportation

self-medication

managing money

strenuous physical activity

heavy work around the house

number of times one can walk one mile or more without rest

increases at .22mm/hr/yr beginning at 20y/o

levels over 80mm/hr coorelate with findings of neoplasm, rheumatic disease, or infection

less than 50 isn't usually an issue

below:

7.5mmol/L in women

8.3mm/L in men

80% of anemic women and 92% of anemic men have normocytic anemia

55% had monoclonal gammopathy of unknown

18% multiple myeloma

12% amyloidosis

about 30% of MGUS patients develop a malignant process in the future

dysarthria

dysphasia

pseudobulbar paralysis

seizures

gait disturbances

Drugs

Emotional illness

Metabolic/endocrine disorder

Eyes/ear/environment

Nutritional/neurologic

Tumor/trauma

Infection

Alcoholism

acute,reversible brain dysfunction

often worse later in the day-sundowning

clouding of consciousness

confusion

irritability

inappropriate behavior

delusions

hallucintions

depression

anxiety

alcohol abuse

somatoform disorders

eating disorders

first test used when patients have memory or cognitive dysunction

24 is the cutoff point for normal

sensitivity of 87-90%

specificity of 80-82%

17 or less is abnormal in those with 8 years or less of education

most common cause of dementia in US nd accounts for 65-75% of all cases

more than 4million affected by it

accumulation of senile plaques in the cerebral cortex and subcortical gray matter

gene mutations on chromosomes 21, 14, and 1

it only accounts for 2% of all cases

higher education

exogenous estrogen

NSAIDs

vitamin E

high monounsaturated fatty acid intake

memory impairment and one or more of:

aphasia, apraxia, agnosia, or disturbance in executive functioning

90%

from BDI, GDS

4.6% annually

over a 4 year period, 10.3% had seen a chiro atleast once

somatic mutation theory

error catastrophe theory

intrinsic mutagenesis theory

family hx of cancer

Alzheimer's

Huntingtons

osteoporosis

hypertension

distinguishes pseudohypertension from hypertension

compresses the proximal artery while occluding the pulse with a finger or bp cuff

symptoms associated with fall

prior falls

location

activity during fall

time of day

1/3 of patients report one or more falls per year 

the rate increases over 85

30-50% of older adults affected

in community dwelling individuals over 65 its 15-30%

women: stress incontinence and urge

men: overflow and urge

52% of males 40-70 have it

but most common btwn 50-70

1/3 deny it when questioned specifically

physicians report as few as 2% of all cases

1. recent ECG changes or acute MI

2. unstable angina/3rd degree hart block or acute CHF

uncontrolled hypertension

cardiomyopathies

uncontrolled metabolic diseases like diabetes, thryoid or adrenal disorders