3 Ageing and Dementia

Question 1

What tool can we use to assess malnutrition?

Answer 1

MUST tool

Malnutrition universal screening tool

Question 2

What effects do ageing have on the respiratory system? Why are these significant?

Answer 2

Lung compliance decreases (reduced elastic support)

Oropharynx can collapse- due to lack of elastic tissue

Atelectasis, pulmonary emboli and pneumonia common POST OPERATIVE complications in elderly

Question 3

Why do we need to be particularly careful if prescribing sedatives/ pain killers to elderly patients?

Answer 3

Obstructive sleep apnoea

Adding insult to injury

Question 4

What do we need to think about when prescribing drugs to elderly patients in terms of pharmacokinetics?

Answer 4

• Elderly patients have increased sensitivity to CNS depressant drugs
• Reduced hepatic and renal function- slower metabolism and elimination of drugs
• Reduce CO- delayed onset of intravenous anaesthesia
• Reduced total body water and increased adipose- alter volume of distribution
• Plasma proteins reduced- increase free drug availability

Question 5

What effects does ageing have on the cardiovascular system? (Generally)

Answer 5

Vessels less elastic

Hypertension

LV hypertrophy

Reduced CO- arm brain circulation time slower (eg anaesthesia)

Question 6

What effects does ageing have on the renal system?

Answer 6

GFR decreased

Prostatism in males- obstructive nephropathy

Question 7

What effects does ageing have on the CNS?

Answer 7

Neuronal density reduce by 30% by 80 yrs

Cerebrovascular disease= common

Question 8

What happens to the thermoregulatory control of a patient as a result of ageing?

Answer 8

May be impaired due to fall in metbaolic activity and reduce muscle mass

Question 9

How is dementia diagnosed?

Answer 9

HISTORY
Examination

Imaging (showing atrophy in brain)