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Year 2 - RDA LCRS 2 > Ageing > Flashcards

Ageing Flashcards

1
Q

Define ageing

A

Ageing is the process of growing older:

  • Biologically
  • Psychologically/cognitively
  • Socially
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2
Q

Define life expectancy

A

Life expectancy is a statistical measure of how long a person can expect to live

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3
Q

Summarise the changing nature of the older population and the demographic changes within society

A

there is a gradual increase in the ageing population

over 85 + is increasing greatly

–> increase in compression of morbidity towards end of life

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4
Q

Summarise the challenges of ageing affecting society

A
  • Working life/retirement balance
  • -> problems with pensions
  • Caring for older people
  • Extending healthy old age not just life expectancy
  • Inadequate services
  • -> delayed transfer of care
  • ageist assumptions perspectives on elderly
  • current medical system = designed for single acute diseases
  • Lack of accessibility for people with disabilities
  • loneliness + isolation
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5
Q

NOTE:

  • people age at different rates

there is discrepancy ebtween chronological age vs biological age

A

-

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6
Q

there is a gradual increase in the ageing population

why might this be?

A
  • improvement in healthcare access
  • improvement in awareness on healthy lifestyle + diet
  • improvement in public care / social care
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7
Q

what is meant by fraility ?

A

a physiological syndrome characterised by decreased reserve and resistance to stressors, resulting from a cumulative decline across multiple physiological systems, –> causing vulnerability to adverse outcomes

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8
Q

How does fraility develop?

A

genetic factors + env factors –> lead to cumulative moelcular and cellular damage –> causes reduced reserved –> which leads to fraility –>

upon stressor event (e.g fall)

  • -> they develop geriatric syndrome (e.g delirium, disability)
  • -> leads to poorer outcomes (needing more care)
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9
Q

what are the main difficulties in managing disease in older people

A
  1. multimorbidity
    - -> 2 or more chronic conditions
    - -> impacts one another
  2. polypharmacy
    - -> causes adverse drug reaction
    - -> due to:
    - multimorbidity,
    - blatantly following guidelines, - undetected non adherance,
    - infrequent review
    - prescription cascade (one drug –> SE –> causes prescription of another drug etc.)
  3. Iatrogenic harm
    - -> adverse drug reactions
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10
Q

What is Comprehensive geriatric assessment (CGA)?

what aspects does it look at?

A
  • multidimensional interdisciplinary assessment that leads to an individualised goal based plan

looks at:

  • physical health
  • mental health
  • functional ability
  • social circumstances
  • environment
  • -> CGA reduces admission
  • reduces inpatient mortality
  • reduces functional/cognitive decline
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11
Q

NOTE: Frail individuals often require rehabilitation to restore functionality

  • rehabilitation
  • prehabilitation e.g before surgery
A

-

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12
Q

What are some Normal cognitive changes in older people

A
  • Processing speed slows
  • Working memory = slightly reduced
  • Simple attention ability preserved,
  • -> but reduction in divided attention
  • reduction in Executive functions
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13
Q

delirium vs dementia

A

delirium
- level of consciousness
- content of consciouessnes
= cognition

dementia:
- -> progressive decline in all domains of cognition
- -> not just memory impairment
- loss of executive function
- functional impairment
- behavioural + psychological changes
- -> lack of insight
- -> progressive
- -> degenerative
- -> irreversible

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14
Q

What are the different types of dementia

A
  • alzheimers’ dementia
  • vascular dementia
  • mixed dementia
  • dementia w lewy bodies
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15
Q

delirium vs dementia

A

delirium
- an acute, global failure of higher brain function

dementia:
- -> progressive decline in all domains of cognition
- -> not just memory impairment
- loss of executive function
- functional impairment
- behavioural + psychological changes
- -> lack of insight
- -> progressive
- -> degenerative
- -> irreversible

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16
Q

what are the 2 higher brain functions

A
  1. consciousness
    +
  2. cognition
17
Q

delirium vs dementia

A

Delirium

  • Acute (hours-days)
  • Fluctuating
  • Main problem with alertness and attention
  • Usually reversible
  • Usually precipitated by something
  • People with dementia are at higher risk
Dementia:  
- Chronic (months-years)
- Gradual progression
- No change in conscious level
Irreversible
18
Q

delirium vs dementia

A

Delirium:

  • Acute (hours-days)
  • Fluctuating
  • Main problem with alertness and attention
  • Usually reversible
  • Usually precipitated by something
  • People with dementia are at higher risk
Dementia:  
- Chronic (months-years)
- Gradual progression
- No change in conscious level
Irreversible
--> can eventually lead to delirium
19
Q

What is dementia

A

dementia:
- -> progressive decline in all domains of cognition
- -> not just memory impairment
- loss of executive function
- functional impairment
- behavioural + psychological changes
- -> lack of insight
- -> progressive
- -> degenerative
- -> irreversible

20
Q

What are some methods of assessing cognitive function?

A

a) Screening tests
- -> AMT, clock drawing test
- -> Mini Mental State Examination (MMSE)
- -> Montreal Cognitive Assessment (MOCA)
- -> 4AT score

b) Diagnostic tests
- -> Addenbrooke’s Cognitive Examination (ACE)
- -> Detailed neuropsychometric testing

21
Q

Montreal Cognitive Assessment (MOCA)

a) what are the advantages of MOCA?
b) what are the disadvantages of MOCA?

A

a) what are the advantages of MOCA?
- Covers a variety of domains of cognitive function
- Brief to administer (10 mins)
- Validated in a range of populations
- Available in translated versions
- Widely used

b) what are the disadvantages of MOCA?
- Education level will affect results
- Language level will affect results
- Floor and ceiling effects
- Can be poorly administered
- Possibly practice/coaching effects

22
Q

NOTE
4AT score
4+ = possible delirum
0 = delirium

A

-

23
Q

What are some problems with cognitive assessment in general?

A
  • Hearing and visual impairment may limit testing
  • Physical problems may limit testing
  • Most assume numeracy and literacy
  • Most assume some basic cultural knowledge
  • Depression can masquerade as dementia
  • Not valid in acute illness
  • Normal cognitive changes (slower processing speed,
  • slower reaction times) may affect administration

Year 2 - RDA LCRS 2 (8 decks)

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