ageing

Question 1

how older population has changed

Answer 1

less poverty in older population, more education, more older ppl of ethnic minorities, and working for longer

Question 2

theories of ageing

Answer 2

PROGRAMMED AGEING- it’s within our DNA, as cells stop dividing at some point as new healthy cells can’t be formed, controlled by TELOMERES: OR DAMAGE/ERROR theories- our cells and DNA accumulates damage eg free radicals

Question 3

problem with theories of ageing

Answer 3

NO current anti-ageing theories

Question 4

issues with society due to ageing

Answer 4

dependency ratio ie working life/retirement balance, extending HEALTHY age rather than just life expectancy, caring for older ppl (SANDWITCH GENERATION), medical system desinged for SINGLE ACUTE diseases

Question 5

issue with working life/retirement balance and link to pension age

Answer 5

to do with dependency ratio ie number of ppl who are retired/in school compared to those working: we are living for longer, so dependency ratio has gone up ie more years spent in retirement, hence pension age has gone up

Question 6

is life expectancy increasing now

Answer 6

has started to tail off in the UK

Question 7

link between healthy years of living and wealth

Answer 7

less deprived ppl have more healthy years

Question 8

social care in the UK

Answer 8

budget has decreased by 40%, as is not free, but rather means tested ie need to pay if you have enough money

Question 9

sandwich generation- mostly male or female

Answer 9

those who have to take care of their children as well as their parents- mostly women

Question 10

define frailty

Answer 10

loss of BIOLOGICAL RESERVE in different organs, leading to vulnerability to a stressor- eg older ppl have less nephrons, if sth effects their kidney, they have less of a reserve of nephrons to cope, OR lung capacity (stressor is walking)

Question 11

how to treat frailty

Answer 11

exercise (increases lung capacity/muscle), nutrition

Question 12

NON-SPECIFIC PRESENTATIONS of frailty

Answer 12

constant falls (lack of muscle reserve), less mobility, recurrent infections (weaker immune system), confusion

Question 13

important thing about non-specific presentation of frailty

Answer 13

older ppl less likely to have classic symptoms of disease if they had eg coronary syndrome ie less likely to have chest pain, instead they have more NON-SPECIFIC symptoms , thus diagnosis of eg infarction more difficult

Question 14

define multimorbidity and significance

Answer 14

2 or more chronic conditions- treatment of 1 condition can affect another ie may not be able to give it, and can lead to POLYPHARMACY (multiple medications)

Question 15

why older ppl take more drugs

Answer 15

multimorbidity, undetected non-adherence (ie doctor adds extra drugs even though 1 would be enough if it was taken properly), infrequent review (not removing drugs if not needed)

Question 16

iatrogenic harm and causes

Answer 16

harm due to treatment- occurs due to frailty (ie reduced reserve), and polypharmacy/comorbidities

Question 17

examples of iatrogenic harm

Answer 17

hospital acquired infections, loss of muscle mass, malnutrition (hospital food not adequate)

Question 18

comprehensive geriatric assessment- what is it and signficance

Answer 18

multidisciplinary assesment of the patient- look at ALL their problems and come up with a plan- reduces falls and admission to hospital

Question 19

rehabilitation

Answer 19

often occurs alongside illness rather than after to prevent muscle loss ie DECONDITIONING

Question 20

changes in ageing brain including grey vs white matter

Answer 20

due to atrophy, VENTRICLES enlarge, and GYRI can be seen more clearly: leads to less white AND grey matter

Question 21

normal cognitive changes in old ppl

Answer 21

slower processing speed/executive functions, less divided attention ie multitasking, but NO change in language, NON-DECLARATIVE memory ie remembering how to do stuff, and VISUOSPATIAL abilities ie shouldn’t get lost in a familiar environment

Question 22

define dementia and is it irreversible

Answer 22

decline in ALL cognitive functions, not ONLY memory eg visuospatial- irreversible

Question 23

screening tests for dementia

Answer 23

AMT, clock drawing test, MOCA (montreal cognitive assessment)

Question 24

diagnostic test for dementia

Answer 24

ACE (addenbroke’s cognitive examination)

Question 25

pros of MOCA

Answer 25

covers variety of cognitive functions, and is brief, range of population BUT education/language level can affect results, administration

Question 26

problems with general cognitive assessmnets

Answer 26

interpretation and context, impairments, numeracy/literacy skills, cultural knowledge