Geriatrics Bundle

Neuroplasticity is the brain's ability to reorganize itself by forming new nerve connections. This is a life-long process that occurs continually as one learns new behaviors, memorizes new data, and as the brain develops. It is a way for the brain to fine-tune itself for efficiency by modifying existing nerve pathways in the brain. Research is showing that exercise enhances this process of neuroplasticity. Exercise promotes increased blood flow to the brain and the upregulation, or increased production of a brain chemical called BDNF, Brain Derived Neurotrophic Factor. BDNF is a growth factor that may slow the progression or even reverse symptoms of neurologic diseases by enhancing synaptic regrowth / neuron rewiring / relearning. It may act to protect the brain from further degeneration. The concentration of BDNF in blood increases in proportion to the intensity of the exercise. Additionally, exercise strengthens the immune system which may also play a role in managing this disease.

Jackie Russell, RN, BSN, CNOR, will present a 45-minute PowerPoint evidence-based discussion of the neuroplastic impact of exercise on degenerative neurologic disease (Parkinson's / Alzheimer's Disease) as well as its effect on the normal aging brain.

After participating in the course, attendees will be able to:

• Explain the life-long process of neuroplasticity and the brain's ability to continually reorganize itself to learn new behaviors, memorize data, and modify existing nerve pathways
• Understand the concept of cognitive resilience and the positive effect that rigorous exercise during the middle stages of life may have on the normal aging process of the brain in later years
• Integrate growing evidence demonstrating neuroplastic, neuroprotective, and neurorestorative positive effects of exercise on Parkinson's disease / Alzheimer's disease

The clinical assessment of gait speed reflects the integrated performance of multiple organ systems, such as the nervous, sensory, musculoskeletal, and cardiopulmonary systems and has been referred to as the “sixth vital sign." Its assessment has been recommended as part of any standard inpatient geriatric evaluation. Gait speed has been shown to be an important clinical indicator of health and predictor of health outcomes. Gait speed has been shown to be a significant predictor of length of hospital stay, discharge disposition from hospital, probability of hospital readmission, and mortality. Gait speed has been suggested to reflect the likelihood of good health and better survival. The physical therapist plays an important role in assessing gait speed and identifying at-risk patients in many different practice settings. Once identified, modifiable factors can be identified and appropriate treatments may be initiated while admitted in hosp ital and beyond the patient’s hospitalization.