100 Geriatric Rehabilitation MCQ with Answers and Explanations

The Fried phenotype uses five findings: unintentional weight loss, exhaustion, weakness assessed by grip strength, slow walking speed, and low physical activity.

• Zero criteria indicate robustness; one or two indicate prefrailty; three or more indicate frailty.
• Frailty reflects reduced physiological reserve, so relatively minor stressors may produce marked functional deterioration.
• It is related to, but distinct from, comorbidity, disability and sarcopenia.

With increasing age, fast-twitch type II fibers are disproportionately affected.

• These fibers contribute to rapid force production and protective reactions such as recovering balance after a trip.
• Age-related muscle impairment also reflects reduced fiber number, altered motor activation, and less efficient neuromuscular transmission.
• Declining power may impair transfers and stair climbing even when slow, low-demand movements remain possible.

Sarcopenic obesity combines excess adiposity with deterioration in muscle mass and function.

• Fat gain may mask muscle loss, so stable body weight or a high BMI cannot exclude clinically important muscle decline.
• Muscle function should be examined directly, for example using grip strength and mobility testing; body composition assessment may also be useful.
• Cachexia differs because it is associated with an underlying disease process and typically involves loss of both muscle and fat.

A history of falls within the preceding year is an important predictor of future falls.

• Ask about the frequency, setting, circumstances, associated dizziness, loss of consciousness, footwear, and injuries.
• Falls usually have multiple contributors, including muscle weakness, impaired vision, balance dysfunction, orthostatic symptoms, medications and environmental hazards.

Older adults commonly exhibit slower walking speed, shorter stride length, increased double-limb support and sometimes a broader base.

• Increased double support can represent an adaptation to reduced confidence or stability.
• Changes in sensory input, strength, joints, balance and cognition contribute.
• Marked gait deterioration should not automatically be attributed to age: painful arthritis, neuropathy, Parkinson disease, medication effects and other disorders may require evaluation.

Usual gait speed reflects the integration of muscular, cardiovascular, sensory, neurological and cognitive functions.

• It can be measured with a marked walkway and a stopwatch, and repeated serially to assess changes or response to rehabilitation.
• A speed around 1.0 m/s has been used as a guidepost for comparatively good function, but values depend on the population and measurement protocol.

Basic ADLs include personal care such as bathing, dressing, toileting, feeding and transfers.

• Instrumental ADLs are more complex community tasks, including shopping, finances, meal preparation, medications and transportation.
• IADLs depend on physical capacity and executive cognitive abilities; they may decline while basic ADLs remain intact.

Bed rest reduces mechanical loading and causes muscle wasting, loss of strength and power, skeletal demineralization and cardiovascular deconditioning.

• Lower-extremity muscles are particularly susceptible.
• Orthostatic intolerance, reduced respiratory capacity, balance deterioration and pressure injury risk may follow.
• These effects can be especially serious in older patients with limited baseline reserves.

Benzodiazepines and other centrally acting medications can produce sedation, slowed reactions, impaired coordination and attention deficits.

• Their effects may be prolonged in older adults because drug distribution and elimination can change with age.
• Medication review should also consider anticholinergics, antidepressants, antiepileptics and opioids.

When fixation, medical stability and surgical precautions permit, early mobilization helps restore safe transfers, standing, gait and self-care.

• Interventions include progressive strengthening, balance training, walking aids and fall prevention.
• Prolonged bed rest worsens muscle loss, orthostatic tolerance and pressure-injury risk.
• The exact schedule and permitted loading depend on fracture pattern, procedure, implant stability and treating surgeon instructions.

For unilateral painful hip disease, a cane is usually held contralaterally: left hand for a painful right hip.

• Advancing the cane with the affected leg creates an external support force and reduces the demand on the painful hip.
• Appropriate height, grip and coordination matter.
• A patient needing greater support or unable to use a cane safely may require a walker.

Normal pressure hydrocephalus commonly presents with gait disturbance, cognitive impairment and urinary dysfunction, together with ventriculomegaly.

• Gait initiation and foot clearance may be impaired, producing a magnetic appearance.
• Other causes of gait and cognitive dysfunction must be considered, and appropriate neurological investigation is required.
• Selected patients may improve after cerebrospinal fluid diversion.

For postmenopausal women and older men to whom T-score criteria apply, osteoporosis is defined densitometrically by a T-score at or below −2.5 at an accepted skeletal site.

• A score between −1.0 and −2.5 indicates low bone mass, whereas −1.0 or above is normal.
• DXA results should be interpreted alongside fracture history and clinical risk.

Delirium is an acute disturbance of attention and awareness with additional cognitive changes and a typically fluctuating course.

• It requires assessment for causes such as illness, metabolic problems, medication toxicity and other physiological insults.
• Dementia may increase vulnerability to delirium but does not explain a new abrupt fluctuating deterioration on its own.

A prescribing cascade begins when an adverse drug effect is misinterpreted as a new illness, prompting another prescription.

• This can create further adverse effects and interactions, especially in older adults with multimorbidity and altered drug handling.
• For new symptoms, review the timing of medication changes and assess all prescribed and nonprescription products.

Grip dynamometry provides a practical estimate of muscle strength; DXA can estimate appendicular lean mass.

• Both dimensions are relevant to sarcopenia assessment.
• Performance tests such as chair rise or gait speed help characterize the functional impact.
• BMI alone is unreliable because muscle loss may be masked by increased fat mass.

Extended recumbency reduces cardiovascular conditioning and can impair adaptation to upright posture.

• On standing, dependent pooling of blood requires compensatory circulatory responses; these may be inadequate after bed rest.
• Dehydration, autonomic dysfunction and medications can contribute.
• Mobilization should progress safely from sitting to standing and walking with appropriate monitoring.

The gastrocnemius crosses both the knee and ankle.

• Knee extension increases its tension, potentially restricting dorsiflexion; knee flexion relaxes it and may improve ankle movement.
• Soleus does not cross the knee.
• This examination finding can help distinguish gastrocnemius tightness from more fixed joint restriction.

Rising from a chair requires lower-extremity strength, balance, coordination and adequate hip and knee movement.

• Repeated sit-to-stand is a task-specific exercise that can be modified using a higher seat, arm supports or assistance and progressed as performance improves.

A daily protein intake around 1.0–1.2 g/kg is recommended for many healthy older adults.

• Sufficient calories and protein support muscle maintenance and recovery, especially alongside resistance exercise.
• Weight loss can result from poor appetite, swallowing problems, depression and difficulty obtaining or preparing food.

Breath-holding while exerting force may cause a Valsalva maneuver, leading to substantial transient cardiovascular changes, including elevations in blood pressure.

• Resistance training is valuable for older adults, but technique and intensity must be appropriate to comorbidities.

Walkers provide a wider support base and greater opportunities for upper-limb assistance than a single-point cane.

• They may suit bilateral weakness or substantial balance instability.
• Selection depends on cognition, endurance, hand function, home constraints and ability to maneuver the device safely.

Parkinsonian motor features can impair gait initiation, turning, step length and postural control.

• Rehabilitation addresses transfers, walking, balance and muscle function using individualized practice and strengthening.
• Exercises should reflect disease severity, cognition and fall risk.
• Bed rest promotes deconditioning and does not address the underlying mobility limitations.

Prosthetic potential depends on pre-amputation mobility, cognition, residual-limb condition, balance, cardiopulmonary reserve and comorbidities.

• Premorbid function may be more predictive than age by itself.
• Prosthetic walking requires additional energy and motor learning.

Multiple interacting impairments may contribute to geriatric disability.

• A coordinated assessment should cover mobility, pain, medications, cognition, nutrition, activities of daily living and environmental barriers.
• Care may combine strengthening, balance and gait training, medication review, home adaptation and goal-based self-care practice.

Semantic memory stores general knowledge, concepts and vocabulary and may remain stable or improve with experience.

• In contrast, processing speed, fluid reasoning, divided attention and aspects of executive function may decline.
• These differences matter when teaching rehabilitation tasks: previously learned knowledge and routines may be useful even when unfamiliar information takes longer to master.

Intrinsic risks arise from the patient, including orthostatic hypotension, sensory deficits, muscle weakness, impaired balance, neurological conditions and cognition.

• External hazards such as poor lighting, rugs and footwear are generally classified as extrinsic.
• Fall risk is multifactorial: both categories should be evaluated and modifiable causes addressed.

Relative body fat commonly increases with age while lean mass and total body water decrease.

• Lipid-soluble drugs may have a larger volume of distribution and sometimes a prolonged half-life; the latter also depends on clearance.
• Water-soluble drugs can have a smaller volume of distribution and greater plasma concentrations.

Frailty reflects diminished reserve; prefrailty offers an opportunity to reduce decline.

• Exercise has been among the most effective interventions studied, with benefits for strength, mobility and physical performance.
• A program may combine resistance, balance and aerobic activities.
• Progression and supervision should match the person’s capabilities, because excessive demands may produce fatigue or other adverse events.

Reaching the head requires coordinated shoulder elevation and external rotation.

• Limited external rotation may make grooming difficult, whereas restricted internal rotation commonly affects reaching behind the back.
• A functional examination links joint range restrictions to specific daily activities.

Pulmonary elastic recoil declines with age and chest-wall movement becomes more restricted.

• Respiratory muscles may weaken, gas-exchange efficiency can decline, and residual volume can increase.
• Older adults may compensate at rest but have less physiological reserve during exertion or acute illness.

Environmental interventions can reduce modifiable fall hazards.

• Lighting, grab bars, safer floor surfaces, suitable bed height and accessible pathways should be matched to the individual’s deficits and routines.
• Recurrent nighttime bathroom trips also justify inquiry about nocturia and medications.

Cerebral atrophy increases the space traversed by bridging veins, increasing their vulnerability to stretching and tearing.

• Vascular changes and anticoagulants may add risk.
• A subdural hematoma may develop gradually after seemingly minor trauma and present with altered cognition, gait or neurological function.

Repeated chair-rise testing assesses combined lower-limb strength, balance and coordination.

• Short-distance timed walking captures functional mobility influenced by joints, neurological control, endurance and cognition.
• Both provide information beyond isolated manual muscle testing.

Intracapsular femoral-neck fractures may compromise the vascular supply to the femoral head, increasing avascular necrosis and nonunion risk.

• Intertrochanteric fractures generally have a more favorable regional blood supply.
• Surgical choice and subsequent rehabilitation depend on fracture characteristics, patient status and fixation or implant stability.

Resistance exercise targeting major muscle groups on two or three nonconsecutive days weekly provides opportunity for training and recovery.

• An illustrative session may include at least one set of 10–15 repetitions, with intensity adapted to fitness and safe technique.
• Benefits include greater strength, power and performance.

Mild age-related slowing differs from cognitive deficits severe enough to interfere with independence.

• Dementia may affect memory, executive function and other domains with meaningful daily-life consequences.
• Mild cognitive impairment typically preserves substantial independence despite measurable decline.

Knee osteoarthritis can cause pain, weakness and activity restriction.

• Strengthening surrounding musculature, including the quadriceps, can improve functional capacity and support mobility.
• Range-of-motion work and task-specific training may also be helpful.
• Management should reflect symptom severity, joint status and comorbidities.

Urinary incontinence becomes more frequent in later life but warrants assessment.

• Patients may avoid reporting it due to embarrassment.
• Ask about urgency, frequency, nocturia, leakage and functional access to the toilet.
• Medications, neurological and urological disease, mobility, cognition and environment may contribute.

Balance depends on integrating visual, vestibular and somatosensory information.

• Sensory organization testing manipulates conditions to examine reliance on these inputs.
• Bedside tasks such as Romberg, tandem standing and single-leg standing can offer useful screening information.

Macular degeneration primarily affects central visual function, compromising reading and recognition of fine detail.

• Glaucoma may cause visual-field loss; cataract can impair clarity and produce glare.
• Visual problems increase environmental navigation difficulty and interact with balance deficits.

Serum creatinine reflects both production from muscle and renal elimination.

• Sarcopenia lowers creatinine generation, so apparently reassuring concentrations may coexist with reduced kidney function.
• Creatinine-based filtration estimates may be misleading in marked muscle loss.
• This is important for dosing renally cleared medications and reducing adverse reactions.

Post-stroke disability often affects multiple domains.

• Rehabilitation can address strength, joint mobility, gait, balance, spasticity, cognition, visual problems and bladder-related limitations.
• Care may begin in the acute setting when appropriate and continue through recovery.

Hallux rigidus is painful stiffness of the first metatarsophalangeal joint.

• Limited motion can interfere with terminal stance and toe-off and promote compensatory gait patterns.
• Hallux valgus involves deviation of the great toe, pes planus refers to arch flattening, and hammer toe affects the lesser toes.

A platform walker permits forearm support and reduces dependence on direct hand or wrist gripping.

• Selection requires assessment of upper-extremity loading tolerance, balance, cognition, endurance and home conditions.
• Proper fitting and supervised training help avoid new overuse symptoms and unsafe compensations.

Changes in taste and smell may reduce enjoyment and variety of food.

• Lower gastric compliance can produce earlier and more prolonged satiety.
• Depression, chewing or swallowing disorders, physical dependence and limited food access may worsen intake.

A practical general target is approximately 30 minutes of moderate-intensity aerobic activity on five days each week.

• Moderate activity noticeably increases breathing and heart rate.
• Walking and cycling are possible modalities.
• The goal must be adapted to medical status and starting fitness; previously sedentary adults often need a prolonged, gradual progression.

Participation restrictions can arise from social or environmental barriers despite relatively preserved physical capacity.

• Transportation support and accessible community resources may restore independence and reduce isolation.
• Rehabilitation includes social work and psychosocial considerations, not only body function.

Tai chi uses controlled movements, weight shifts and postural transitions that can challenge balance.

• Other activities include dynamic standing tasks, strengthening, yoga and suitably adapted aerobic exercise.
• For a person with severe instability, supervision and progression from simpler supported tasks may be needed.

Complex geriatric disability often results from interacting medical, psychological and social factors.

• Assessment should identify practical limitations, safety risks, cognitive needs, medications and available support.
• A coordinated team can prioritize goals meaningful to the patient, such as transfers, bathing or safe walking.

People with longstanding impairments may depend on compensatory muscular strength, mobility and sensory reserves.

• Aging can diminish those reserves and expose formerly manageable limitations.
• Pain, degeneration, deconditioning and reduced social support may add to decline.
• Investigate for new treatable illness rather than assuming aging is the sole cause.

Maximal heart rate and maximal oxygen uptake tend to decline with advancing age.

• Arterial stiffness, changes in ventricular filling and reduced adrenergic responsiveness contribute to diminished reserve.
• Illustrative rates vary widely between individuals and activity levels.

Executive function supports planning, organization, sequencing and mental flexibility, all crucial for IADLs such as finances or medication management.

• The Trail-Making Test includes attentional and set-shifting demands.
• Screening should be interpreted alongside hearing, vision, education and functional history.

Dual-task walking places simultaneous demands on gait control and attention.

• In older adults with limited cognitive reserve, the combined load can reduce walking speed, increase step variability or compromise balance.
• Observing gait during a simple cognitive task can reveal limitations not apparent during ordinary walking.

Immobility produces prolonged loading over bony areas.

• Moisture from incontinence, skin fragility and inadequate nutritional status further impair tissue tolerance and healing.
• Prevention includes pressure redistribution, appropriate repositioning, skin inspection, moisture care, nutrition and early safe mobilization.

Bisphosphonates inhibit osteoclast-mediated bone resorption and are established treatments for osteoporosis in selected patients.

• Fracture prevention also requires assessment of falls, strength, balance and home safety.
• Exercise cannot substitute for indicated medical therapy, just as medication does not eliminate mobility-related risks.

The amount of strength required for standing may represent a larger fraction of the maximum available in an older person.

• Reduced reserve means a routine task can become tiring despite apparent ability to perform it.
• This principle also applies to transfers and stair climbing.

Footwear changes loading, ankle mechanics and sensory information.

• Lower heels can provide a more favorable, stable support pattern for many older adults.
• Fit, sole grip, comfort, foot deformity and skin integrity are relevant.
• Selected supportive shoes or orthoses may be useful, but should follow individual assessment.

Hip extension is needed as the trunk advances over the stance limb.

• Restriction can reduce step progression and contribute to shorter strides or compensatory movement patterns.
• Pain, joint degeneration and soft-tissue stiffness may be responsible.

A complete medication review includes all substances actually taken, including products obtained without prescriptions.

• Anticholinergic, sedating and interacting drugs can contribute to confusion, dizziness and falls.
• Review the indication, benefit, timing, dosage, renal elimination and potential interactions.

Cachexia is disease-associated wasting that typically involves loss of skeletal muscle and fat, often with weight loss.

• It is distinct from sarcopenic obesity, where excess adiposity coexists with poor muscle quantity and function.
• The mechanisms may overlap but differ in clinical context.

Presbycusis is age-associated hearing loss that is commonly bilateral and symmetrical with prominent high-frequency impairment.

• Cochlear aging, genetic factors, noise and ototoxic exposure may contribute.
• Hearing problems can reduce communication and the ability to follow therapy instructions.

Degenerative discs and joints can narrow the spinal canal, leaving less space for the spinal cord.

• A relatively small trauma may then produce substantial neurological consequences in susceptible patients.
• Degenerative stenosis can also cause nontraumatic cord dysfunction.

Lower-limb muscles are normally loaded by standing and walking, so bed rest greatly reduces their usual mechanical stimuli.

• This contributes to atrophy and losses in strength and power, undermining transfers and gait.
• Bone demineralization and orthostatic intolerance can occur simultaneously.

During recumbency, fluid accumulated in dependent tissues may return to the central circulation and increase nocturnal urine production.

• Nocturia has other causes, including urological disorders, medications and systemic conditions, so evaluation is needed.

Inversion and eversion contribute to foot adaptation as the surface changes.

• Restricted motion may interfere with uneven-ground walking, especially when accompanied by poor proprioception or strength.
• Assess foot deformity, ankle range, joint stability, footwear and balance.

Early mobilization where fixation and medical status allow can reduce deconditioning and restore independence after hip fracture.

• Interventions include pain control, transfer practice, walking aids, strengthening and fall prevention.
• Surgical restrictions must be respected; a blanket rule of prolonged immobility is inappropriate.

Bone strength reflects a balance between osteoclast resorption and osteoblast formation.

• With aging and estrogen decline after menopause, resorption may exceed formation and progressively weaken bone.
• Inactivity and reduced mechanical loading further contribute.

Low-fitness older adults need graded activity, sometimes over months, before reaching broad exercise targets.

• A safe program begins with feasible duration, intensity and frequency and progresses according to tolerance.
• Medical illness, fall risk and personal preference affect selection.

Mobility depends on much more than isolated force generation.

• Joint restriction, reduced power, poor coordination, sensory loss, pain, cognition and endurance may impair walking.
• Balance tests, repeated chair rises and timed walking help identify practical deficits.

Older adults may have reduced drug clearance and greater vulnerability to sedation, confusion, gastrointestinal bleeding and falls.

• Exercise, functional training and other nonpharmacological approaches can support pain management.
• Medication choices should consider kidney function, interactions and patient goals, with follow-up for benefit and harm.

Aging skin often has reduced thickness, moisture, elasticity, perfusion and capacity for repair.

• Sensory changes may further delay recognition of injury.
• This matters for wheelchair seating, bed positioning, transfers and moisture management.

Cognitive impairment can interfere with new learning and executive control, but meaningful rehabilitation remains possible.

• Use clear instructions, familiar functional activities, repetition, supervision and caregiver involvement when appropriate.
• Safety and the patient’s preferences guide progression.

Isometric exercise generates force with minimal visible joint movement and may be tolerable when dynamic motion causes pain.

• It can help maintain activation during early rehabilitation.
• Breathing technique matters because strenuous sustained contractions with breath-holding can markedly affect blood pressure.

Geriatric rehabilitation is patient-centered.

• An independently chosen goal such as bathing may require balance, transfers, reach and environmental adaptation, even if maximal gait distance is not the most important immediate outcome.
• Family input matters for caregiving and safety, but should not automatically displace the patient’s preferences.

Muscle power depends on generating force rapidly.

• With aging, altered motor neuron excitability, agonist–antagonist coactivation, neuromuscular transmission and disproportionate type II fiber loss can impair power.
• Rapid protective steps and chair-rise performance may suffer even when slow movements are possible.

Primary aging denotes changes attributable to biological aging itself.

• Secondary aging refers to additional decline arising from illness, injury, disuse or other influences.
• Both usually coexist.
• Distinguishing them helps clinicians search for modifiable contributors rather than accepting every symptom as inevitable.

Arterial stiffness increases systolic pressure and ventricular loading.

• Age-related cardiac changes may include hypertrophy and reduced diastolic reserve, with less efficient relaxation and filling.
• Responses to exertion and circulatory stress may be limited.

Direct questions to the older person whenever possible and allow sufficient time.

• Explore recent changes in falls, sleep, pain, mobility, appetite, urinary symptoms, medications and ADLs.
• Caregiver information can clarify difficulties when cognition or communication is impaired, but should supplement rather than automatically replace the patient’s account.

Renal mass, perfusion and concentrating capacity may decrease with aging.

• Reduced ability to conserve water can contribute to dehydration, especially when intake is limited or illness raises losses.
• Dizziness, orthostatic symptoms and reduced exercise tolerance may follow.

Vision, vestibular input and somatosensation are integrated to maintain posture.

• When proprioceptive information is poor, patients may depend more heavily on vision, leading to instability when visual cues disappear.
• Significant deficits may indicate neuropathy or another neurological condition rather than aging alone.

Bone adapts to weight-bearing and forces transmitted through muscle contraction.

• Bed rest removes these stimuli, favoring muscle atrophy and bone demineralization.
• The combination produces weakness, frailty and higher fracture vulnerability.

Low-grade inflammation can promote catabolic pathways and reduce anabolic responsiveness in skeletal muscle.

• TNF-α and IL-6 are associated with these processes, while C-reactive protein is a marker of inflammatory activity.
• Sarcopenia remains multifactorial: inactivity, inadequate nutrition, hormones and neural changes also matter.

Hypochlorhydria may influence digestion and availability of nutrients, including vitamin B12 and certain minerals.

• Age-related changes in taste, smell and gastric compliance can also reduce intake and produce early satiety.
• Individual deficiencies have several causes, so assessment must be specific.

Anabolic hormonal influences, including testosterone, growth hormone and insulin-like growth factor, can decline with age and influence muscle protein metabolism.

• Hormones are only part of the mechanism: inactivity, inflammation, nutrition and neurological factors contribute.

Procedural memory supports learned skills and habits.

• Episodic memory is responsible for autobiographical events and often shows greater vulnerability during aging.
• Semantic memory, including vocabulary and knowledge, may remain relatively intact.

Estrogen deficiency contributes to postmenopausal bone loss, and hormone therapy can influence fracture risk in selected situations.

• Nevertheless, routine use solely to treat established osteoporosis is limited by risk–benefit considerations.
• Raloxifene also carries thromboembolic risks.

Festinating gait is associated with Parkinson disease and features short, progressively accelerating steps, often with forward displacement.

• Parkinsonian gait may also show shuffling, reduced arm swing, hesitation on initiation and difficulty turning.
• Steppage gait is more characteristic of dorsiflexor weakness, while Trendelenburg gait reflects hip abductor insufficiency.

Older adults retain the ability to adapt to aerobic training.

• Potential benefits include improved maximal oxygen uptake, muscle oxygen use, blood pressure regulation and conditioning.
• Improvement varies with baseline fitness, adherence and comorbid illness.

Disease-specific guidelines may not capture interactions among several illnesses and treatments.

• A medication added for one condition may worsen falls or cognition, while intensive treatment can impose substantial burden.
• Integrated geriatric care prioritizes safety, function, meaningful benefit and patient wishes.

Age-related hearing loss can make spoken instructions difficult to follow and may be mistaken for poor attention or cognition.

• Sensory assessment, clear communication, appropriate volume and positioning, and hearing evaluation can support safe participation.

Cancer rehabilitation in older adults is influenced by treatment effects, frailty, comorbidities, cognition and premorbid function.

• Care may target fatigue, mobility, endurance, self-care and quality of life, with precautions individualized to medical stability.

Oral NSAIDs can reduce osteoarthritis pain but may impair kidney function and contribute to gastrointestinal bleeding, especially in susceptible older adults.

• Treatment choices require consideration of medical history, interactions and the patient’s functional goals.

Support networks can determine access to shopping, transportation, self-care assistance and community activity.

• Bereavement and isolation may also contribute to depression and reduced engagement.
• Rehabilitation should assess resources and practical barriers, with social work and community services when indicated.

Shoe inserts or custom foot orthoses can support selected patients with symptomatic foot deformities.

• Prescription should reflect pain, foot alignment, skin integrity, footwear fit and walking needs.
• The goal is improved comfort and mobility rather than correcting appearance alone.

Mobility depends on endurance, strength, joint movement and postural control.

• Aerobic exercise improves conditioning; resistance exercise supports force and power; stretching maintains motion; balance practice addresses stability.
• These complementary components should be individualized to activity goals, medical status and baseline ability.

Mild cognitive impairment describes acquired cognitive decline greater than expected for age without the marked loss of daily independence characteristic of dementia.

• Symptoms may involve memory or other cognitive domains.
• Some patients progress, others remain stable or improve; progression is not inevitable.

Water-soluble medications distribute within aqueous compartments.

• Reduced total body water can decrease distribution volume, so a fixed dose may yield a higher concentration.
• Drug handling also depends on metabolism, excretion, interactions and individual circumstances.

Disability may arise when environmental design does not match the user’s mobility needs.

• A doorway that prevents safe walker passage is an accessibility barrier, not necessarily a strength deficit.
• Altering layouts, improving access, grab bars and lighting can improve independence.

Acute illness and inactivity can produce disproportionate functional decline in older adults.

• Evaluate medical stability, ADLs, transfer ability, gait, balance, medications, nutrition and prior falls.
• Treatment may combine graded mobilization, strengthening, functional training, dietary assessment and environmental adaptations.