Chronic Disease Management in Older Adults Flashcards

According to current US guidelines, the target blood pressure for adults aged 65 and older without significant comorbidities is:

Answer: <130/80 mmHg

The 2017 ACC/AHA guidelines recommend a BP target of <130/80 mmHg for most adults ≥65, including those with high cardiovascular risk.

A 70-year-old patient with type 2 diabetes has an A1C of 9.2%. The most appropriate A1C target for this otherwise healthy older adult is:

Answer: <7.5%

For healthy older adults with diabetes, the ADA recommends an A1C target of <7.5%, balancing glycemic control with hypoglycemia risk.

Which class of antidiabetic medication is considered high-risk in older adults due to its association with severe hypoglycemia?

Answer: Sulfonylureas

Sulfonylureas stimulate insulin secretion independent of blood glucose levels, making them high-risk for hypoglycemia in older adults with irregular eating patterns.

When managing heart failure with reduced ejection fraction (HFrEF) in an 80-year-old, which medication class has demonstrated mortality benefit and should be initiated?

Answer: Beta-blockers

Beta-blockers (carvedilol, metoprolol succinate, bisoprolol) are evidence-based, guideline-directed therapy for HFrEF that reduce mortality and hospitalizations.

An older adult with COPD is most appropriately staged using which classification system?

Answer: GOLD Staging System

The GOLD (Global Initiative for Chronic Obstructive Lung Disease) staging system uses spirometry results and symptom burden to classify COPD severity and guide treatment.

A 75-year-old with CKD stage 3b (eGFR 32 mL/min) and type 2 diabetes should have metformin:

Answer: Discontinued

Metformin is contraindicated when eGFR falls below 30 mL/min, and should be discontinued at eGFR <30 due to lactic acidosis risk; at eGFR 30–45, dose reduction is advised.