Ageing 1 Flashcards
What is ageing and what does it involve
the process of growing older
involves multiple aspects:
→ Biological
→ Psychological/cognitive
→ Social
What is the life expectancy of a baby girl born in England today
83
What is population ageing
Population ageing is simply increasing average life expectancy – life expectancy in increasing in almost country.
What are some reasons for population ageing
Better nutrition Better public Health - better sanitation, fewer infectious diseases Better education Less violence Better education
What are the reasons fr the changing nature of the older population
Increasing numbers of BAME older people Increasing education of older people Reduction in poverty More people are working for longer More complex/nuanced retirement process
What are the 2 theories for ageing
Programmed ageing
Damage or error theories
Summarise the programmed ageing theory
Evidence provided by the Hayflick limit (cells in culture would only undergo a certain number of divisions)
This involved telomeres that shorten with each division
Summarise the savage or error theory of ageing
-
What challenges does society face as a result of population ageing?
Working life/retirement balance - dependency ratio
Extending healthy old age not just life expectancy
Caring for older people, the sandwich generation
Outdated and ageist beliefs/assumptions
Medical system designed for single acute diseases
Describe how working life/retirement balance - dependency ratio presents a challenge to ageing
Most older people are content with their lives, possibly 60-70s are the happiest time.
Biggest fear is losing independence
Change in pension schemes and working life
What is the healthy life expectancy in males and females
Male HLE 63.4 (20%)
Female HLE 64.0
What is health in older age dependent on
Health in older age is not random.
Only a small proportion is due to genetic inheritance. Most is due to ongoing interactions between broader characteristics of individuals and the environments they inhabit.
What factors contribute to our social position and to our ability to access resources
Sex and ethnicity
Occupation
Educational attainment
Wealth
Give factors in the environment the tcontribute to ageing
we live, our transportation options, and the health-care systems and long-term care systems that we can access.
What is the sandwich generation and what proportion are women and in paid work
1.25m sandwich carers in the UK
caring for an older relative
whilst bringing up children
68% women
78% also in paid work
What proportion of over 65s live in a care home
31%
Why does care for the elderly and its changes present a problem for ageing
81% of councils have reduced the amount they spend on social care despite an ageing population.
26% fewer people are getting help – unclear what is happening to them
Councils are reducing/freezing the amount they pay care agencies
Define frailty
Loss of biological reserve across multiple organ systems, leading to vulnerability to physiological decompensation and functional decline after a stressor event
What can be sued to treat/prevent frailty
Exercise
Nutrition
Drugs (possibly)
Prevention is better than cure
Give some non-specific presentations of ageing
Falls Reduced mobility Recurrent infections Confusion Weight loss “Not coping” Iatrogenic harm
Describe multi-morbidity
Multi-morbidity is two or more chronic conditions
Conditions impact on one another
Treatment for one condition may impact on another
What are the negative impacts of multi-morbidity
Worse QoL, more likely to be depressed
Increased functional impairment
Burden of treatment
Polypharmacy
Why are older people taking more drugs (poly pharmacy)
Multimorbidity Guidelines/QOF/NICE Undetected non adherence Infrequent review Poor communication
What proportion of prescriptions are inappropriate
40%
What negative outcomes are poly pharmacy associated with
Falls
Increased length of stay
Delirium
Mortality
What proportion of inpatients are affected by iatrogenic harm and how many are avoidable
2-36% of inpatients, in which half are probably avoidable
Describe the Nosocomial conditions of the hospital
Infections Pressure sores Constipation Deconditioning Delirium Malnutrition Incontinence
Describe how adverse drug reactions contributes to disease in old age
Up to 17% of hospital admissions are due to drug reactions
The more medications taken, the greater the risk
NSAIDs are most likely to be the cause of a hospital admission
Why are older people at an increased risk of harm from drugs
Reduced physiological reserve Impaired compensation mechanisms Comorbidities Polypharmacy Cognitive impairment
