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JAAPA CME Post-Test April 2017
Postoperative Confusion in Older Adults | Exercise: A Vitally Important Prescription
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Postoperative Confusion in Older Adults

Freddi Segal-Gidan, PA, PhD

The development of postoperative confusion in older patients is increasingly being recognized as clinically significant because it is becoming more common as the population ages. Postoperative delirium and postoperative cognitive dysfunction differ in time course of development. Risk factors other than age include certain medications as well as anesthesia (both the type and amount used). Postoperative delirium and postoperative cognitive dysfunction appear to increase a patient’s risk for developing dementia. Routine preoperative screening may help to identify patients with preexisting cognitive impairment who are at greatest risk for developing postoperative delirium or postoperative cognitive dysfunction.

Learning Objectives

Upon completion of this activity, participants will be able to:

  • Describe the occurrence of postoperative confusion in older adults and explain the various manifestations that commonly occur.
  • Discuss the use of preoperative screening that can assist with identification of preexisting cognitive impairment and predict postoperative risk for developing confusion.

Exercise: A Vitally Important Prescription

Rachel L. Hechanova, MPAP, PA-C; Jennifer L. Wegler, MMSc, MA, PA-C; Christopher P. Forest, MSHS, DFAAPA, PA-C

Sedentary lifestyles and low physical activity have led to rising health concerns and increasing mortality risks. With the growing concern of the inactivity of adult Americans, it is important that physical activity be promoted to prevent disease and reduce health risks. This activity reviews the benefits of physical activity and the steps that primary care providers should take to evaluate physical activity as the fifth vital sign in every patient encounter. The 5A’s (assess, advise, agree, assist, and arrange) should be applied in order to implement an exercise prescription into the practice of medicine.

Learning Objectives

Upon completion of this activity, participants will be able to:

  • Discuss the epidemiology of physical inactivity and the associated risks of morbidity and mortality.
  • Explain the benefits of physical activity and describe steps that healthcare providers should take to evaluate patients’ level of activity.
  • Discuss the application of the 5A’s in implementing an exercise prescription.

Accreditation Statement


This activity has been reviewed and is approved for a maximum of 1.0 AAPA Category 1 CME credit by the AAPA Review Panel. Participants should only claim credit commensurate with their participation in the CME activity. This program was planned in accordance with AAPA’s CME Standards. 

Disclosure Policy Statement

It is the policy of AAPA to require the disclosure of the existence of any significant financial interest or any other relationship a faculty member has with the commercial interest of any commercial product discussed in an educational presentation. The participating faculty reported the following:

Freddi Segal-Gidan is an assistant professor of clinical neurology, family medicine, and gerontology at the University of Southern California (USC) in Los Angeles and director of the Geriatric Neurobehavior & Alzheimer’s Center and Rancho/USC California Alzheimer’s Disease Center at Rancho Los Amigos National Rehabilitation Center in Downey, Calif. Rachel L. Hechanova practices emergency medicine in several hospitals in Los Angeles County, as well as in Goleta Valley, Calif. Jennifer L. Wegler practices orthopedics at the Kootenai Medical Center in Coeur D’Alene, Idaho. She previously was a clinical instructor of family medicine in the PA program at the University of Southern California (USC) in Alhambra, Calif. Christopher P. Forest is an assistant professor of clinical family medicine at USC’s Keck School of Medicine and practices urgent care and family medicine in Los Angeles, Calif.The authors has disclosed no potential conflicts of interest, financial or otherwise.

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Type:     Journal-based CME
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