AMC Clinical Geriatric Assessment 1 — Questions and Answers
Question 1: Which assessment tool is most commonly used to measure functional independence across activities of daily living in elderly patients?
- Mini-Mental State Examination (MMSE)
- Barthel Index (Correct answer)
- Geriatric Depression Scale (GDS)
- Timed Up and Go test (TUG)
Correct answer: Barthel Index
The Barthel Index assesses functional independence across 10 activities of daily living including feeding, bathing, grooming, dressing, and mobility, making it the standard functional assessment tool in geriatric medicine.
Question 2: An 82-year-old woman presents after her second fall this month. Which single intervention has the strongest evidence for reducing fall risk in community-dwelling older adults?
- Calcium and vitamin D supplementation
- Medication review with withdrawal of high-risk medications (Correct answer)
- Hip protectors
- Home safety modifications alone
Correct answer: Medication review with withdrawal of high-risk medications
Medication review with withdrawal of psychotropic and other high-risk medications has the strongest evidence base for fall prevention in community-dwelling older adults, as these drugs directly impair balance and coordination.
Question 3: On the Mini-Mental State Examination (MMSE), which score range indicates moderate dementia?
- 24–30
- 18–23
- 10–17 (Correct answer)
- Below 10
Correct answer: 10–17
MMSE scores of 10–17 indicate moderate dementia, while 18–23 indicates mild, 24–30 is normal or very mild impairment, and below 10 indicates severe dementia.
Question 4: A 78-year-old man with known dementia becomes acutely confused and agitated in hospital. Which feature most distinguishes delirium from worsening of his underlying dementia?
- Presence of visual hallucinations
- Acute onset with a fluctuating course (Correct answer)
- Cognitive impairment
- Disorientation to time and place
Correct answer: Acute onset with a fluctuating course
The cardinal feature distinguishing delirium from dementia is its acute onset and fluctuating course over hours to days, whereas dementia follows a gradual, progressive decline over months to years.
Question 5: According to the Fried Frailty Phenotype, which combination of criteria defines frailty?
- Three or more of: unintentional weight loss, exhaustion, low physical activity, slow gait speed, and grip weakness (Correct answer)
- Two or more of: weight loss, cognitive impairment, low physical activity, slow gait, and weakness
- Three or more of: weight loss, cognitive impairment, incontinence, slow gait, and social isolation
- Two or more of: weight loss, exhaustion, low physical activity, slow gait, and cognitive impairment
Correct answer: Three or more of: unintentional weight loss, exhaustion, low physical activity, slow gait speed, and grip weakness
The Fried Frailty Phenotype defines frailty as meeting 3 or more of 5 specific criteria: unintentional weight loss, self-reported exhaustion, low physical activity, slow gait speed, and grip weakness.
Question 6: When reviewing medications in a 75-year-old patient using the Beers Criteria, which drug class is most commonly identified as potentially inappropriate in older adults due to fall and cognitive risks?
- ACE inhibitors
- Benzodiazepines (Correct answer)
- Beta-blockers
- Statins
Correct answer: Benzodiazepines
Benzodiazepines are among the most frequently flagged medications in the Beers Criteria for older adults due to their associated risks of falls, cognitive impairment, motor incoordination, and sedation.
Question 7: Which nutritional screening tool was specifically developed and validated for use in elderly populations aged 65 and over?
- Malnutrition Universal Screening Tool (MUST)
- Mini Nutritional Assessment (MNA) (Correct answer)
- Nutritional Risk Screening 2002 (NRS-2002)
- Simplified Nutritional Appetite Questionnaire (SNAQ)
Correct answer: Mini Nutritional Assessment (MNA)
The Mini Nutritional Assessment (MNA) was specifically developed and validated for screening and assessing nutritional status in elderly patients aged 65 and older, making it the preferred tool in geriatric settings.
AMC Clinical Geriatric Assessment 1
Which assessment tool is most commonly used to measure functional independence across activities of daily living in elderly patients?