The Propensity and Consequences of Falls among the Elderly

Chapter 127 The Propensity and Consequences of Falls among the Elderly




Clinical Case Problem 1: An 81-Year-Old Woman Who Is Repeatedly Falling


An 81-year-old woman who is repeatedly falling is brought to the office by her daughter. The elderly mother has been falling repeatedly for at least 3   months. The falling has been getting progressively worse, and the patient’s daughter is very concerned about the possibility of her mother “breaking her hip.”


On examination, the patient is a frail, elderly woman in no acute distress. She appears somewhat depressed. Her Mini-Mental State Examination score is 27. The patient’s blood pressure is 180/75   mm Hg. Her pulse is 84 beats/minute and irregular. No other abnormalities are found.



Select the best answer to the following questions




1. What is the prevalence of falls among community- based elderly patients between the ages of 70 and 75   years?


a. 5% per year

b. 10% per year

c. 20% per year

d. 30% per year

e. 50% per year

2. Which of the following statements regarding falls in the elderly is (are) true?


a. the prevalence of falling in the elderly increases with advancing age

b. elderly patients who are physically active may be at greater risk of falling than those who are not

c. approximately 55% of elderly patients who fall once will fall again

d. falling in the elderly may not necessarily be a marker of functional decline

e. all of the above statements are true

3. Which of the following is the most feared outcome of falling among elderly patients?


a. fracture of the hip

b. fracture of the radius

c. subdural hematoma

d. epidural hematoma

e. cervical fracture

4. Potential reversible causes of falling in the elderly include which of the following?


a. medications

b. postprandial hypotension

c. alcohol use

d. urinary urgency

e. all of the above

5. Which of the following are predisposing risk factors for falls in the elderly?


a. visual impairment

b. cerebrovascular accidents

c. Alzheimer disease

d. normal-pressure hydrocephalus

e. all of the above

6. Regarding the incidence of falling and medication use in the elderly, which of the following statements is (are) true?


a. multiple drug use is associated with an increased incidence of falling in the elderly

b. the higher the drug dosage, the greater the probability of falling

c. drug interactions are a major contributing factor to an increased incidence of falling in the elderly

d. a and b

e. a, b, and c

7. Falling in the elderly is most commonly associated with which of the following pathophysiologic factors?


a. orthostatic hypotension

b. decreased left ventricular output

c. decreased cerebral circulation

d. increased left ventricular output

e. none of the above

8. Which of the following medications is most likely to lead to a serious fall in an elderly patient?


a. amitriptyline

b. hydrochlorothiazide

c. enalapril

d. nifedipine

e. fluoxetine

9. What is the prevalence of falling among institutionalized elderly patients?


a. 50% per year

b. 40% per year

c. 30% per year

d. 20% per year

e. 10% per year

10. Which of the following statements regarding the use of restraints in elderly patients as a means to prevent falls is (are) true?


a. restraints have been shown to reduce the incidence of falling in the elderly

b. no study has ever shown a decrease in falls with restraint use in the elderly

c. potential complications of restraint use in the elderly include strangulation, vascular damage, and neurologic damage

d. a and c

e. b and c

11. What percentage of elderly patients are not able to get up after a fall?


a. 10%

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Oct 1, 2016 | Posted by in GENERAL SURGERY | Comments Off on The Propensity and Consequences of Falls among the Elderly

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