Essentials of the Geriatric Examination
Evidence suggests that musculoskeletal dysfunction is the most significant factor influencing late-life disability. As increasing numbers of elderly patients request chiropractic care, it is critical to know how to distinguish normal age-related changes in neuromusculoskeletal and mental function from true pathology.
This article utilizes a review of the literature to highlight key elements of the geriatric examination, with particular focus on the components of appropriate neuromusculoskeletal, mental status, and functional assessment procedures. Topics presented include modifications needed when examining elderly patients and a review of normal vs. pathologic age-related changes. Several tables and charts serve to illustrate key elements for clinicians to consider when evaluating this special-needs population.
Several efficient and effective evaluation strategies are also discussed. A locomotor screen called GALS is presented, which helps identify functional impairments through a brief history and a six-step evaluation process. The ankle brachial index is presented as an outcome measure that can be easily used in practice to detect and track peripheral arterial disease. A brief evaluation to assess patients' mental status orientation, cognition and memory is also included. (This evaluation can be performed in a matter of moments.)
The article also contains a discussion of common risk factors and warning signs for progressing age-related changes to the neuromusculoskeletal system and mental status. Included with the paper is a clinical algorithm for the differential diagnosis of dementia.
Morgenthal AP. The geriatric examination: neuromusculoskeletal system and mental status examinations. Topics in Clinical Chiropractic
Reprints: (800) 638-8437