List 3 risk factors that accelerate the epigenetic clocks.  

Ms. Foster is a 78 y.o. female who is brought to your office by her daughter. Ms. Foster lives alone in an apartment, and her daughter is concerned about her ability to carry on living independently. Her daughter tells you that her mother began having difficulty with her memory 2 years ago, and since that time she has deteriorated in a slow, steady manner. However, she is not totally incapacitated. She is able to perform some of the activities of daily living, including dressing and bathing. When she cooks for herself, however, she often leaves burners on, and when she drives the car she often gets lost. She has had four motor vehicle accidents in the past 3 months. Her daughter became alarmed when she learned that her mother had gone to the bank and withdrawn the entire contents of her $80,000 savings account to give to her new boyfriend. She had asked for the entire amount in $1 bills and argued with the bank teller when learning that this was impossible. The daughter states that her mother’s memory and confusion have been getting worse. Her personality has changed; her kind and caring mother now displays periods of both agitation and aggression. On exam, the patient’s MMSE is 15/30. Her blood pressure is 140/90 mmHg and her pulse is 84/min. The CV/Resp and abdominal system exams are normal. A detailed neurologic and musculoskeletal exam cannot be carried out because the patient could not follow instructions. Based on this history, what is the most likely diagnosis in this patient?

Which medication is associated with significant side effects in the elderly? 

Which of the following is true regarding STOPP/START criteria for prescribing medications? Select all that apply.

Based on the American Geriatrics Society 2023 Beers Criteria, what medications should be used with caution in older adults?  Select all that apply. 

Ms. Smith is 49 years old and sees her PCP for an annual physical. In addition, she is worried about getting Alzheimer’s because her mother was diagnosed with Alzheimer’s disease (AD) at 78 years of age. Ms. Smith has no memory issues. There are no other family members with AD. She states that she read on the internet that Alzheimer’s is related to the APOE 4 genetic mutation. What is the best explanation for Mr. Smith?

Mr. Sours is 90 years old. In the last few months, he appears unable to comply with the health-care plan developed by the nurse practitioner. The nurse practitioner considers which of the following reasons for non adherence when updating his home care plan? Select all that apply.

The nurse practitioner has conducted a thorough health assessment for Mr. York, who is 83 years old. As the nurse practitioner synthesizes the information and creates the discharge instructions, consideration must be given to which of the following? Select all that apply.

Which of the following test may help identify elders who are at increased risk for falling?

Which of the following combinations of pharmacologic agents is most commonly associated with adverse drug reactions (ADRs) in the elderly?