1: Frailty

Question 1

Define frailty

Answer 1

State of increased vulnerability to poor resolution of homeostasis after a stressor event

Question 2

What does frailty mean

Answer 2

Individuals can appear with straightforward symptoms with underlying complex frailty syndromes

Question 3

What are the 5 frailty syndromes

Answer 3

Delirium 
Incontinence
Immobility 
Falls 
Susceptibility to side effects of medications

Question 4

How is frailty meant to be prevented

Answer 4

All GPs should complete an electronic frailty index for patients >65y

Question 5

What is used in practice to assess frailty

Answer 5

Rockwood Clinical Frailty Score

Question 6

What is 1 on the Rockwood clinical frailty score

Answer 6

Robust, active, energetic and motivated. Fit for their age

Question 7

What is 2 on the Rockwood clinical frailty score

Answer 7

No active disease symptoms, but less fit than 1.

Question 8

What is 3 on the rockwood frailty score

Answer 8

Medical problems well controlled but not regularly active

Question 9

What is 4 on the rock wood clinical frailty score

Answer 9

Symptoms limits activity

Question 10

What is 5 of the rockwood clinical frailty score

Answer 10

Slowing, need help with ADL

Question 11

What is 6 on the rockwood clinical frailty score

Answer 11

Need help with outdoor actives, possibly stairs and bathing

Question 12

What is 7 on the rockwood clinical frailty score

Answer 12

Completely dependent for personal care

Question 13

What is 8 on the rockwood clinical frailty score

Answer 13

Completely dependent and nearing end-stage life

Question 14

What is 9 on the rockwood clinical frailty score

Answer 14

< 6 months

Question 15

What may be used in primary care to assess frailty

Answer 15

Gait speed 
Timed up and go test
Grip strength 
PRIMSA 7 
Rockwood clinical frailty score

Question 16

How are frail patients managed

Answer 16

Comprehensive geriatric assessment

Question 17

What is a comprehensive geriatric assessment

Answer 17

Clinical management strategy that gives a framework to deliver interventions which address issue for the patient

Question 18

What are 4 indications of the comprehensive geriatric assessment

Answer 18

1. Elderly person presents to GP with frailty syndrome
2. Discharged from hospital with a frailty syndrome
3. Community team learns of frailty
4. Care home

Question 19

What are the 4 elements of the comprehensive geriatric assessment

Answer 19

1. Physical assessment
2. Psychological
3. Social and environment
4. Medication review

Question 20

What tool may be used to perform a social and environmental assessment

Answer 20

Nottingham extended activities of daily living scale

Question 21

What is used to grade the severity of pressure ulcers

Answer 21

Waterlow Score

Question 22

What is grade-1 waterlow score

Answer 22

• Non-blanchable erythema of intact skin

- Discolouration of skin, warmth, oedema

Question 23

what is grade 2 waterlow score

Answer 23

• Partial thickness skin loss (epidermis or dermis)
• Ulcer is superficial
• Presents as abrasion or blister

Question 24

what is grade 3 waterlow score

Answer 24

• Full thickness skin loss

- Involves damage or necrosis to subcutaneous tissue that may extend to, but NOT through underlying fascia

Question 25

what is grade 4 waterlow score

Answer 25

Extensive destruction, tissue necrosis, damage to muscle or bone.