Ageing 1

Question 1

What is ageing and what does it involve

Answer 1

the process of growing older

involves multiple aspects:
→ Biological
→ Psychological/cognitive
→ Social

Question 2

What is the life expectancy of a baby girl born in England today

Answer 2

83

Question 3

What is population ageing

Answer 3

Population ageing is simply increasing average life expectancy – life expectancy in increasing in almost country.

Question 4

What are some reasons for population ageing

Answer 4

Better nutrition 
Better public Health - better sanitation, fewer infectious diseases
Better education 
Less violence 
Better education

Question 5

What are the reasons fr the changing nature of the older population

Answer 5

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

Question 6

What are the 2 theories for ageing

Answer 6

Programmed ageing

Damage or error theories

Question 7

Summarise the programmed ageing theory

Answer 7

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

Question 8

Summarise the savage or error theory of ageing

Answer 8

-

Question 9

What challenges does society face as a result of population ageing?

Answer 9

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Outdated and ageist beliefs/assumptions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

Question 10

Describe how working life/retirement balance - dependency ratio presents a challenge to ageing

Answer 10

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

Question 11

What is the healthy life expectancy in males and females

Answer 11

Male HLE 63.4 (20%)

Female HLE 64.0

Question 12

What is health in older age dependent on

Answer 12

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.

Question 13

What factors contribute to our social position and to our ability to access resources

Answer 13

Sex and ethnicity
Occupation
Educational attainment
Wealth

Question 14

Give factors in the environment the tcontribute to ageing

Answer 14

we live, our transportation options, and the health-care systems and long-term care systems that we can access.

Question 15

What is the sandwich generation and what proportion are women and in paid work

Answer 15

1.25m sandwich carers in the UK
caring for an older relative
whilst bringing up children

68% women
78% also in paid work

Question 16

What proportion of over 65s live in a care home

Answer 16

31%

Question 17

Why does care for the elderly and its changes present a problem for ageing

Answer 17

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

Question 18

Define frailty

Answer 18

Loss of biological reserve across multiple organ systems, leading to vulnerability to physiological decompensation and functional decline after a stressor event

Question 19

What can be sued to treat/prevent frailty

Answer 19

Exercise
Nutrition
Drugs (possibly)
Prevention is better than cure

Question 20

Give some non-specific presentations of ageing

Answer 20

Falls
Reduced mobility
Recurrent infections
Confusion
Weight loss
“Not coping”
Iatrogenic harm

Question 21

Describe multi-morbidity

Answer 21

Multi-morbidity is two or more chronic conditions
Conditions impact on one another
Treatment for one condition may impact on another

Question 22

What are the negative impacts of multi-morbidity

Answer 22

Worse QoL, more likely to be depressed
Increased functional impairment
Burden of treatment
Polypharmacy

Question 23

Why are older people taking more drugs (poly pharmacy)

Answer 23

Multimorbidity
Guidelines/QOF/NICE
Undetected non adherence
Infrequent review
Poor communication

Question 24

What proportion of prescriptions are inappropriate

Answer 24

40%

Question 25

What negative outcomes are poly pharmacy associated with

Answer 25

Falls
Increased length of stay
Delirium
Mortality

Question 26

What proportion of inpatients are affected by iatrogenic harm and how many are avoidable

Answer 26

2-36% of inpatients, in which half are probably avoidable

Question 27

Describe the Nosocomial conditions of the hospital

Answer 27

Infections
Pressure sores
Constipation
Deconditioning
Delirium
Malnutrition
Incontinence

Question 28

Describe how adverse drug reactions contributes to disease in old age

Answer 28

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

Question 29

Why are older people at an increased risk of harm from drugs

Answer 29

Reduced physiological reserve
Impaired compensation mechanisms
Comorbidities
Polypharmacy
Cognitive impairment