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CASE STUDY 3 Geriatric Syndrome: Falls, Polypharmacy, and Cognitive Change

Case Scenario

Mr. A.S. is a 78-year-old male presenting after two falls in the past month.

History:

ยท PMH: HTN, osteoarthritis, insomnia, BPH

ยท Medications: Hydrochlorothiazide, diphenhydramine nightly, tamsulosin, ibuprofen PRN

ยท Reports dizziness and forgetfulness

Vitals:

ยท Orthostatic BP positive

ยท MMSE: borderline impairment

Student Assignment Requirements

1. Pathophysiology (25%)

ยท Aging physiology and medication sensitivity

ยท Mechanisms of orthostasis and cognitive impairment

ยท Fall-related morbidity

2. Geriatric Assessment (35%)

ยท Medication reconciliation and Beers Criteria application

ยท Cognitive and fall-risk evaluation

ยท Functional and safety assessment

3. Pharmacology & Deprescribing Plan (30%)

ยท Identification of high-risk medications

ยท Deprescribing strategy with rationale

ยท Non-pharmacologic interventions

4. APA & Professional Writing (10%)