UNIT 4: COMMON DISORDERS IN THE AGING 4.3 GERIATRIC SYNDROMES: IMMOBILITY

Immobility is the decreased ability to perform activities of daily living and it is caused by impairment of motor functions.

Immobility syndrome is the common pathway of disease presentation. It is generated by a series of pathophysiological changes in multiple systems, conditioned by immobility and disuse. Cause is multifactorial, potentially reversible and preventable.

Decreasing physical functionality is a known consequence of aging. Older adults show a large deterioration in motor skills due to the reduction in strength and muscle volume, decreased speed and skill of the march, leading to concomitant motor impairment and disability (AS Buchman, 2009).

Immobility syndrome prevention

1) Primary: The best preventive measure is to keep the degree of mobility. Several studies agree that physical exercise as the main factor preventing immobility. The benefits of exercise do not decrease with age. Improving muscle strength and therefore improves ambulation, increases bone mass, improving hyperglycemia, lowers blood triglyceride levels and increase HDL cholesterol, etc. It also reduces anxiety and depressive symptoms. It is recommended starting the exercise 2 or 3 days a week to reach 5.

Healthy elderly subjects are divided into two groups: <75 years: moderate exercise to high intensity aerobic and resistance, and in> 75 years moderate effort exercises.

2) Secondary prevention: Once detected the clinic may include a number of changes in the environment that encourage commuting and encourage the maintenance of autonomy. These measures include: avoiding architectural barriers, maintain the sensory, technical adjustments, encourage independence. On a practical level should be taken into account:

a. Doors: amplitude, weight, easy to open or close.

b. Rooms and corridors: amplitude, if accurate mobilization wheelchairs, etc.

c. Furniture: remove furniture that may interfere with ambulation, and place them as help or support point.

d. Railings: for support.

e. Lighting: adequate, with switches in accessible and comfortable.

f. Floors: carpet removal, cables or cords. Slip resistant surfaces and ramps instead of stairs.

g. WC: Using grab bars, lifts the toilet bowl, bathtub non-slip surface, easy entry and exit from the tub by seats.

h. Personal Hygiene: adaptations in the sponge, combs and brushes, care of the folds, mouth and dentures.

i. Dress: replacing zippers and Velcro buttons, garment open in front and slip resistant soles in shoes. To dress the lower body will be easier to do in supine starting with the extremity disabilities.

j. Chairs: solid, heavy, high back and arms.

k. Bedding: preferably height adjustable cushions person or use

3) Tertiary prevention: treatment of complications such as joint contractures, stiffness, muscle atrophy, osteoporosis, etc. It starts with postural control involves body alignment body symmetrically avoiding antalgic postures. Includes repositioning every two hours initially.

Technical aids: canes (support the 15.20% of total body weight), crutches, walkers, wheelchairs, etc..

RESOURCES:

Treaty for geriatric residents. Spanish Society of Geriatrics and Gerontology. 
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