The 4 M’s Framework: Case History and Physical Examination of Older Adults

Overview

Source: Jennifer A. Ouellet and Jaideep Talwalkar; Yale School of Medicine

To meet the needs of older adults, all health professionals should be well acquainted with the history and physical examination considerations unique to this population. Physical examination plays an important role in the older patient to detect physiologic changes of aging, risk factors, and signs of pathology. While most of the general principles of the standard examination for adults apply to older patients, there are additional specific considerations. For example, focused examinations of cognitive and functional status are critical, as are assessments of hearing, vision, nutritional status, and the nervous system. This video will provide an overview of key aspects of the physical examination in older adults, including the use of standardized tools such as the 4 M's, the Timed Get Up and Go, and the Mini-Cog.

Procedure

1. General considerations in the older adult

Prior to beginning the physical examination, ensure that the patient is comfortable (that is, not in pain, does not need to use the restroom) and ask about any specific sensory considerations that you should be aware of during the encounter (that is, vision and hearing impairment).
Observe for nutritional deficiencies, including malnutrition. Monitor for weight loss on recent visits or changes in the fit of clothing. Assess for temporal wasting, atrophy o

Results

	Normative Range	Abnormal Test
Pulse Pressure (systolic blood pressure-diastolic blood pressure)	40 mmHg	>40 mmHg may indicate stiff vasculature 2/2 atherosclerosis
Orthostatic Vitals		Systolic Blood Pressure Standing < 10 mmHg than S Log in or to access full content. Learn more about your institution’s access to JoVE content here Tags 4 M s Framework Physical Examination Older Adults Age Friendly Health System What Matters Mobility Medications Mentation Polypharmacy Beers List Deprescribing Cognitive Impairment 跳至... 0:00 Overview 4:29 General Considerations in the Older Adult 6:25 What Matters 7:44 Medication 9:27 Mentation 12:00 Mobility 政策使用条款隐私联系我们向图书馆推荐 JoVE 新闻简报科研 JoVE Journal 技术专题合集 JoVE Encyclopedia of Experiments 档案教育 JoVE Core JoVE Business JoVE Science Education JoVE Lab Manual 教师资源中心 Faculty Site 发表概述发表流程编辑部范围和政策同行评审常见问题提交稿件图书馆员概述客户评价订阅访问权限资源图书馆咨询委员会常见问题关于 JoVE 概述管理层博客 JoVE Help Center 版权所属 © 2024 MyJoVE 公司版权所有，本公司不涉及任何医疗业务和医疗服务。