Ageing Flashcards
What is sarcopenia?
The reduction of skeletal muscle mass, strength and performance with age
What does sarcopenia coexist with?
Frailty, multiple comorbidities, polypharmacy and falls
How is sarcopenia diagnosed?
Slow gate (Less than 4m in 5 seconds) Poor grip strength (
Management of sarcopenia?
Progressive resistance exercise 2-3/week for at least 3 months
Regular increase in physical activity (walking)
Improved dietary intake (1-1.2g/kg body weight/day
Primary sarcopenia is due to?
Age
1-2% muscle mass lost each year after 40
Why is muscle lost each year after the age of 40?
Anabolic resistance, oxidative damage, decreased myofibre innervation
Secondary sarcopenia is due to?
Reduced physical activity (eg bed rest, zero gravity) Poor nutrition (eg inadequate dietary protein intake, malabsorption) Disease related (malignancy, inflammatory disease, endocrine)
Risk factors for 1º sarcopenia
Low birth weight
Poor growth during childhood and puberty
Obesity
What is SARC-F?
Assessment tool for sarcopenia
Ability to carry a heavy load, walk, rise from a chair, climb stairs and assess fall frequency
What is frailty?
A state of increased vulnerability to stressors due to reductions in physiologic reserve in multiple body systems.
Vulnerable to adverse health outcomes
Just about coping until ‘trivial infection’
Signs and symptoms of frailty
Exhaustion Weakness Weight loss>5kg in year Slow walking speed Low physical activity
What is the anorexia of ageing?
Decreased olfaction, increased satiety
Poor dentition, impaired gut function
Decreased access to food/functioning
Interventions for frailty?
Dinner table, protected meal times
Feeding help and fortified food
Exercise and mobility (Tai Chi)
Why are long lies important to pick up?
Urinary retention-> UTI AKI Rhabdomyolysis Hypothermia Pressure sores
What is delerium?
Acute confusion secondary to a cause
What is delerium defined by?
Disturbance of consciousness (decreased attention)
Change in cognition or perceptual disturbance (incoherent/disorganised thinking)
Acute (hours/days) and fluctuant
Evidence of a cause
How common is delerium in intensive care and palliative care?
80% and 85%
What needs to be assessed in delerious patients?
Baseline functioning from collateral history
Time course
Drug and medical history
Vital signs, hydration
Bitten tongue, signs of head injury, fractures
Autonomic innervation
Any cranial nerve palsies/motor deficits
10 causes of delerium?
Drugs (opiates, polypharmacy) Sensory deficits Low PO2 Infection Urinary/faecal retention Ictal state Underhydration/nutrition Subdural haematoma Pain Glycaemic control
