7/30/2019 Geriatric Disorders

1/21

7/30/2019 Geriatric Disorders

2/21

Is common neurodegenerative disease of theelderly .typically beginning in the 60s 0r 70s

Definition:Chronic progressive disease of the CNSDegeneration of the dopaminergic neuron at

the substantia nigra =depletion of dopamine

7/30/2019 Geriatric Disorders

3/21

Genetic environmental trigger

Lack of dopamine

7/30/2019 Geriatric Disorders

4/21

RigidityBradykinesia

Resting tremorPostural in stability

7/30/2019 Geriatric Disorders

5/21

Increase the resistance to the passive motion Slowness and difficulty in maintain the

movement Dependence in daily tasks Involuntary movement: present at rest , dis

appear in voluntary movement

7/30/2019 Geriatric Disorders

6/21

Carbidopa- levodopa Dopamine agonists

7/30/2019 Geriatric Disorders

7/21

Cognitive status:Mini mental status exam scorePsychological function:Depression symptomsPhysical status :ROM

MMTPOSTUREBALANCEGAIT

7/30/2019 Geriatric Disorders

8/21

Exercises:According to your finding but mainly used

ROMStrength exercisesBalance exercisesGait trainingResistance exercisesRelaxation

7/30/2019 Geriatric Disorders

9/21

Dementia is a term used to describea some symptoms including:

Forgetfulness (progressive)Difficulty doing familiar tasks

Confusion

Poor thinking

Decline in intellectual functioning

7/30/2019 Geriatric Disorders

10/21

Memory impairment: impaired ability tolearn new information or to recall old

information One or more of the following: aphasia

(language disturbance); apraxia (impairedability to carry out motor activities despiteintact motor function); agnosia (failure torecognize or identify objects despite intactsensory function)

7/30/2019 Geriatric Disorders

11/21

the cognitive deficits result in functionalimpairment (social/occupational

Physical changes

7/30/2019 Geriatric Disorders

12/21

Alzheimers disease (approximately 70%)Vascular dementia (Strokes and TIAs)Parkinsons diseaseFrontotemporal dementia (FTD)DepressionOther, less common causes

7/30/2019 Geriatric Disorders

13/21

Physiotherapy has been reported to have

very positive effects on demented patients.Through treatment physiotherapists arehoping to slow the loss of cognitive functionas evidenced by some of the literature.Regular movement, particularly following aregime recommended by a physiotherapist,improves flexibility and strength.

7/30/2019 Geriatric Disorders

14/21

Dementia can result in issues ,less balanceleading to a higher risk of falls which,

amongst the elderly in particular, can lead tobroken bones and dislocations. Balance andstability exercises help reduce the risk offalling

7/30/2019 Geriatric Disorders

15/21

Demented patients can often becomeaggressive and depressed. Regular movementhas been shown to stabilise their mood, easing

depression and keeping them calm. Similarly alevel of activity is beneficial in terms ofimproving sleep patterns which can often bedisrupted by dementia. Physiotherapists will usemany tools to get demented patients practicinga regular routine, these include householdroutines, exercises classes, and resistancetraining and stretching

7/30/2019 Geriatric Disorders

16/21

progressive neurologic disorder that results inmemory loss, personality changes, globalcognitive dysfunction, and functional

impairments.Loss of short-term memory is mostprominent early.In the late stages of disease, patients aretotally dependent upon others for ADLS

the most common form of dementia in theelderly, accounting for 60 to 80 % of casesestimated to affect more than 4 millionAmericans

7/30/2019 Geriatric Disorders

17/21

Memory loss for recent events

Progresses into dementia almost total

memory loss Inability to converse, loss of language ability Affective/personality disturbance Physical distrabance

7/30/2019 Geriatric Disorders

18/21

Clinical diagnosis History, mental status evaluation, physical

examination, limited laboratory testing, andin many cases, neuroimaging, more extensiveneuropsychological testing and a depressionscreen.

7/30/2019 Geriatric Disorders

19/21

Exercises to improve or maintain muscle strength Exercises to maintain range of movement Balance exercises to prevent risk of falls

Provision of mobility aids and equipment to keeppeople as active and safe as possible Home assessments to advise on safety within the

persons own environment and possible adaptationsto maximise independence

Advice to family and carers on ways to safely handlethe person

Providing a home exercise programme for the personto complete with support of their family if necessary

7/30/2019 Geriatric Disorders

20/21

Improved muscle strength

Improved range of movement Improved mobility Maintenance of safety Reduced risk of falls Improved confidence and quality of life Maintenance of independence for as long as

possible

7/30/2019 Geriatric Disorders

21/21

www.manchesterneurophysio.co.uk/alzheimers-disease/physiotherapy-for-alzheimers-

disease.html http://www.healthcentre.org.uk/physiothera

pists/physiotherapist-dementia.htm

http://www.manchesterneurophysio.co.uk/alzheimers-disease/physiotherapy-for-alzheimers-disease.htmlhttp://www.manchesterneurophysio.co.uk/alzheimers-disease/physiotherapy-for-alzheimers-disease.htmlhttp://www.manchesterneurophysio.co.uk/alzheimers-disease/physiotherapy-for-alzheimers-disease.htmlhttp://www.healthcentre.org.uk/physiotherapists/physiotherapist-dementia.htmhttp://www.healthcentre.org.uk/physiotherapists/physiotherapist-dementia.htmhttp://www.healthcentre.org.uk/physiotherapists/physiotherapist-dementia.htmhttp://www.healthcentre.org.uk/physiotherapists/physiotherapist-dementia.htmhttp://www.healthcentre.org.uk/physiotherapists/physiotherapist-dementia.htmhttp://www.healthcentre.org.uk/physiotherapists/physiotherapist-dementia.htmhttp://www.manchesterneurophysio.co.uk/alzheimers-disease/physiotherapy-for-alzheimers-disease.htmlhttp://www.manchesterneurophysio.co.uk/alzheimers-disease/physiotherapy-for-alzheimers-disease.htmlhttp://www.manchesterneurophysio.co.uk/alzheimers-disease/physiotherapy-for-alzheimers-disease.htmlhttp://www.manchesterneurophysio.co.uk/alzheimers-disease/physiotherapy-for-alzheimers-disease.htmlhttp://www.manchesterneurophysio.co.uk/alzheimers-disease/physiotherapy-for-alzheimers-disease.htmlhttp://www.manchesterneurophysio.co.uk/alzheimers-disease/physiotherapy-for-alzheimers-disease.htmlhttp://www.manchesterneurophysio.co.uk/alzheimers-disease/physiotherapy-for-alzheimers-disease.htmlhttp://www.manchesterneurophysio.co.uk/alzheimers-disease/physiotherapy-for-alzheimers-disease.htmlhttp://www.manchesterneurophysio.co.uk/alzheimers-disease/physiotherapy-for-alzheimers-disease.htmlhttp://www.manchesterneurophysio.co.uk/alzheimers-disease/physiotherapy-for-alzheimers-disease.html