This talk will focus on the normal aging process in older adults. Specifically, the faculty will discuss hormonal changes, including changes in estrogen and testosterone levels. The faculty will also review physiologic changes and speak to how age impacts the circadian pattern of body temperature, cortisol levels, and sleep. Following this session, you will have a full picture of possible treatments—as well as their risks and benefits—for common symptoms associated with age-related hormonal changes.

The role of the primary care clinician is crucial in defining the quality of care and life a patient experiences in the final months and year. Caring for patients longitudinally is core to the principles of primary care. Even nearing the end, there is always more we can do, and navigating and supporting patients in crafting what optimal care looks like for them in key to the alleviation and prevention of suffering and enhancement of quality of life as disease progress. In this talk we will explore practical clinical, communication, and operations skills to integrate of palliative care principles into primary care, at all stages of a serious illness.

Mobility disorders are a menace of old age, often resulting in falls, injuries, and especially hip fractures -- the sixth leading cause of death in the elderly. Primary care physicians have difficulties in both detecting and correctly identifying these abnormalities. In a paper published in the Journal of the American Geriatrics Society in 2004 [52(9):1527-31], the authors concluded that "community physicians appear to underdetect falls and gait disorders, leading to a paucity of recommendations and treatments." Hence the need to revisit the most common gait abnormalities. This multimedia presentation will provide a panorama of bipedalism, from its origin six million years ago in the savannahs of East Africa, to its rise as the unique trait of our species, and eventually to its status as a major cause of disability once full bipedalism is lost. The talk will review the physiology of ambulation and the prevalence of gait disorders in the population. In addition to detailed information on psychogenic and antalgic gaits, participants will learn about the seven major gait abnormalities. Whenever possible, the speaker will enliven the delivery by reviewing "famous patients," or vignettes of historical figures and celebrities who suffered the disorder.

Now that the capabilities of medicine provide increasingly complex care and technology to keep patients alive in health states they might not desire, the clinician is responsible for anticipating future care needs and guiding treatments as patients become more ill and less functional. Advance care planning is an essential tool in the primary care practitioner’s armamentarium, and this skill set must be honed to ensure that patients receive care consistent with their informed preferences and appropriate to their prognosis. Clinicians must feel comfortable introducing advance care planning, carrying out serial discussions with patients about prognosis, using appropriate tools and practice structures, and coordinating care among the team of clinicians caring for their patients across care venues. Sometimes the process requires setting limits and addressing maladaptive coping. Building strong relationships with patients and families and a consistent focus on goals of care is key to high quality treatment for the complex patient and achieving optimal end of life care.

Falls are a major cause of morbidity and serious health issues in older adults that can have devastating outcomes. Using real-world cases and audience participation, this lecture will discuss a hands-on approach to identifying fall risks, preventing falls, assessing patients post-fall, and treating older adults. Office-based balance and gait assessments that can be conducted in small spaces will be demonstrated. Evidence will be presented about updated recommendations on fall treatments, including simple recommendations to multi-level interventions that improve the care of older adults. Advice on selecting the right durable medical equipment (e.g., canes, walkers, rollators, wheelchairs, and scooters) and measuring for the correct size equipment will be provided. Very few people outlive their canes so many older adult patients use hand-me-downs, resulting in poor posture, gait instability, and additional falls. After attending this lecture, you will understand how to best care for your older adult patients who are prone to fall. Please note that any data, indications, and guidelines presented in this activity are current as of the recording/release on February 8, 2020, and they are subject to change as new information is published.

This session aims to refresh your knowledge and stimulate interest in performing a thorough and focused physical exam (PE), particularly in the geriatric population. Whether part of a Medicare evaluation or a routine office visit, the PE provides an opportunity to develop rapport, trust, and potentially to discover clinically significant findings that might otherwise have gone unrecognized. A series of brief scenarios will be used to illustrate important yet basic concepts such as differentiation between normal age-related findings versus indicators of worrisome disease processes and atypical presentation of disease. Now, Let’s Get Physical! Please note that any data, indications, and guidelines presented in this activity are current as of the recording/release on February 8, 2020, and they are subject to change as new information is published.

Polypharmacy, defined as the use of multiple drugs or more than are medically necessary, is a growing concern for older adults. With older adults living longer and experiencing multiple chronic comorbidities, medication regimens are becoming increasingly complex and lengthy. It is not unusual to see patients taking 10 or more medications. Unfortunately, polypharmacy has been associated with an increased risk of adverse drug events (ADEs), drug-interactions, medication non-adherence, reduced functional capacity and multiple geriatric syndromes. This lecture will present real-world cases of polypharmacy and review the concepts of de-prescribing, what medications are no longer considered helpful to older adults, and how to safely reduce polypharmacy in real-world settings among patients.

This session aims to refresh your knowledge and stimulate interest in performing a thorough and focused physical exam (PE), particularly in the geriatric population. Whether part of a Medicare evaluation or a routine office visit, the PE provides an opportunity to develop rapport, trust, and potentially to discover clinically significant findings that might otherwise have gone unrecognized. A series of brief scenarios will be used to illustrate important yet basic concepts such as differentiation between normal age-related findings versus indicators of worrisome disease processes and atypical presentation of disease. Now, Let’s Get Physical!

With the COVID-19 Pandemic, older adults have experienced severe illness, increased hospitalizations, and mortality at alarming rates. Nursing homes and long-term care retirement communities emerged as COVID-19 hotspots with rampant outbreaks. Every older adult diagnosed with or exposed to COVID-19 have realized the potential ramifications. Providers have been at the forefront of mediating these decisions. Dr. Lindquist will discuss how long-term care and end-of-life planning has been impacted by COVID-19. Utilizing real-world examples with older adults and experiences in home-based and nursing home care, Dr. Lindquist will showcase how to prepare older adults and their loved ones for the consequences of COVID-19.

It is important to recognize and address cognitive complaints and dementia symptoms early in the disease continuum and as part of routine care. Steps to diagnose mild cognitive impairment and Alzheimer’s disease will be discussed, as will the importance of early treatment. Approaches to Alzheimer’s disease prevention, including lifestyle changes, will be presented, along with emerging disease-modifying therapies.

This podcast can help you to differentiate between normal age-related memory decline, mild cognitive impairment, and dementia so that you can diagnose your patients with memory loss correctly and provide them with the best management for their condition.

What do primary care providers need to know to know about hypertension, polypharmacy in the elderly, and asthma? Join cardiologist Karol Watson, geriatrician Lee Lindquist, and pulmonologist Sunjay Devarajan as they review important questions, they get asked about these three topics! Please note that any data, indications, and guidelines presented in this activity are current as of the recording/release on 12/4/2020 and they are subject to change as new information is published.