Aging MSK

Question 1

Aging spine

Answer 1

Increased kyphosis of the thoracic spine and lordosis of the lumbar spine. Decreased height due to this.

Caused by osteoporosis and osteopenia

• increased risk of compression fracture in the spine

Question 2

Common clinical sign of hip fracture in elderly

Answer 2

Shortened and externally rotated leg with pain on weight bearing.

Question 3

Risk factors for falling

Answer 3

• previous falls greatly increase
• impaired balance. Vision and gait ,muscle strength, cognitive impairment (Geriatric syndromes)
• more than 4 meds at one (especially if psychoactive sounds and sedatives are involved)
• being female increases risk of falling

Older than 80

Has low BMI, arthritis, pain depression, urinary incontinence and dizziness

Question 4

Fragility fractures

Answer 4

1/2 women, 1/5 men over the age of 50 can suffer fragility fractures

At age 50: more likely that women experience fragility fractures than break, ovarian and uterine cancers combined

Question 5

Polymyalgia Rheumatica (PMR)

Answer 5

Inflammatory condition in multiple muscles

• signs include aching/stiffness/ weakness of girdle and proximal legs and hips/shoulders
• often shows as polyarthraligia as well
• only seen in patients older than 50 years
• is associated with Giant cell arthritis and malignancies such as multiple myeloma
• marked by increased ESR and CRP markers
• easily treated with low-dose corticosteroids

Question 6

Aging components

Answer 6

Decline in structure and function

Impaired maintenance and repair system

Increases susceptibility to disease and death

Reduced reproductive capacity

Vulnerable to therapeutic interventions (risk increases the older they are

Question 7

Causes of aging

Answer 7

Oxidative stress (Most common)

Mitochondrial dysfunction

Impaired autophagy

Telomere shortening

Altered gene expression (Least common)

Overall more likely to see multiple symptoms at once in older patients (especially >80)

Question 8

Interventions for elderly

Answer 8

Focused more on preventative approaches to the causes of aging instead of individual diseases

Question 9

Osteoarthritis treatment in elderly

Answer 9

Can use oral NSAIDs unless renal and GI bleeds but is usually not recommended

• usually uses acetaminophen unless liver issues or topical NSAIDs/Lidocaine since they have less function on GI and renal system
• can use tramadol but DONT use opiates
• can use OMM unless contraindicated

Question 10

Most common mortality reasons in elderly

Answer 10

1 heart disease (>75 age)