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:

dvanced Primary Care of Family I-HBN-HY01 Luis Serrano

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

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:

• PMH: HTN, osteoarthritis, insomnia, BPH
• Medications: Hydrochlorothiazide, diphenhydramine nightly, tamsulosin, ibuprofen PRN
• Reports dizziness and forgetfulness

Vitals:

• Orthostatic BP positive
• MMSE: borderline impairment

Student Assignment Requirements

1. Pathophysiology (25%)

• Aging physiology and medication sensitivity
• Mechanisms of orthostasis and cognitive impairment
• Fall-related morbidity

2. Geriatric Assessment (35%)

• Medication reconciliation and Beers Criteria application
• Cognitive and fall-risk evaluation
• Functional and safety assessment

3. Pharmacology & Deprescribing Plan (30%)

• Identification of high-risk medications
• Deprescribing strategy with rationale
• Non-pharmacologic interventions

4. APA & Professional Writing (10%)

RUBRIC – CASE STUDY 3 – Geriatric Falls, Polypharmacy & Cognitive Change (100 Points)

1. Aging & Pathophysiology (25 points)

Level	Description
Excellent (23–25)	Demonstrates strong understanding of age-related physiologic changes and medication sensitivity with direct application to falls and cognition.
Satisfactory (18–22)	Correct explanation with minor gaps or limited synthesis.
Unsatisfactory (13–17)	Partial understanding of geriatric physiology.
Poor (1–12)	Inaccurate or minimal explanation.
Not Submitted (0)	Section not submitted or missing.

 

2. Geriatric Assessment & Safety (35 points)

Level	Description
Excellent (33–35)	Comprehensive geriatric assessment including falls, cognition, medications, and safety planning.
Satisfactory (26–32)	Assessment covers major areas but lacks depth or prioritization.
Unsatisfactory (18–25)	Incomplete or fragmented assessment.
Poor (1–17)	Clinically unsafe or insufficient evaluation.
Not Submitted (0)	Section not submitted or missing.

 

3. Pharmacology & Deprescribing (30 points)

Level	Description
Excellent (28–30)	Identifies high-risk medications and presents a safe, patient-centered deprescribing plan supported by evidence.
Satisfactory (22–27)	Deprescribing plan is reasonable but incomplete.
Unsatisfactory (16–21)	Limited understanding of medication risk or deprescribing principles.
Poor (1–15)	Unsafe medication decisions.
Not Submitted (0)	Section not submitted or missing.

 

4. APA & Professional Writing (10 points)

(Same descriptors as Case 1)

Submission

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