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LCRS 1 > Ageing > Flashcards

Ageing Flashcards

1
Q

What is ageing/senescence

A

Process of growing old

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2
Q

2 theories behind ageing

A
  • accumulation of damage to DNA for example loss of telomeres or oxidative damage
  • programmed ageing describe how immunological, genetic and hormonal changes over time lead to ageing
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3
Q

Main difference between 2 ageing theories

A

DNA theory suggests that ageing could be reversed

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4
Q

What does population ageing refer to

A

Increasing age of a whole country due to increasing life spans and falling fertility rates

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5
Q

Define life expectancy

A

Statistical measure of the number of years a person can expect to live

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6
Q

What is the challenge of an elderly persons presentation

A

Very often is atypical and there is a non-specific presentation of disease

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7
Q

What does a non-specific presentation mean

A

Underlying pathology is not immediately or clearly linked to the presentation. Falls, delirium and reduced mobility are very common reasons for elderly people seeking medical attention but underlying problems can actually be the cause

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8
Q

What are the giants of geriatric medicine

A 
Immobility
Intellectual impairment
Instability
Incontinence
Iatrogenic problems
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9
Q

Problems with the giants of geriatric medicine

A

Mislead patients and doctors as they attribute symptoms to old age which can delay treatment

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10
Q

What is frailty in medical terms

A

Loss of functional reserve among older people causing impairment of their ability to manage everyday activities. Increases the likelihood of adverse events and deterioration when faced with minor stressor

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11
Q

What is special about medicine for the elderly

A

Multidisciplinary team consisting of doctors, nurses, therapists and social workers etc

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12
Q

Need for multidisciplinary team in medicine for elderly

A

Most of the time present with a large range of symptoms

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13
Q

Problems associated with drug treatments for the elderly

A

Changes in pharmacodynamics and pharmacokinetics can make drug treatments in the elderly more likely to harm them- doctors have to think twice about prescribing them
Most drug trials have few elderly people in so evidence for their effects on the elderly are very understudied

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14
Q

What changes does the brain undergo in ageing

A

Increased volume of CSF
Widening of ventricles
Widened major gyri

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15
Q

Changes in the size of brain throughout life

A

Reaches maximum weight around 20 years of age and remains at this weight until40-50years. Decreases by 2-3%/decade following this

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16
Q

What is abnormal about cognitive development in the elderly

A

Changes in cognitive ability are normal but severe impairment indicates a problem

17
Q

Reason for low rates of dementia diagnosis

A

Combination of misinterpretation- its normal for the elderly to have memory problems
Fatalism- we cant do anything about it so no point diagnosing it
Social isolation- no one is around them to notice

18
Q

Difference between dementia and delirium in terms of onset

A

Dementia chronic and progressive

Delirium is acute

19
Q

Difference between dementia and delirium in terms of cause

A

Dementia- alzheimers and vascular (can be unclear)

Delirium- infection or medication changes (normally a clear precipitant)

20
Q

What group of people is delirium common in

A

Dementia sufferers- delirium can also lead to dementia

21
Q

Progression of dementia

A

Starts with memory issues then leads to include all cognitive functions

22
Q

Name given to condition where people dont quite meet the dementia criteria

A

Mild cognitive impairment- have mild problems but dont yet impair their day to day life

23
Q

2 tests for cognitive impairment

A

Clock drawing

Abbreviated mental test

24
Q

Tools used to distinguish between dementia and delirium

A

Confusion assessment method

4AT

25
Q

What is 4AT test

A

Clinical test used to rapidly diagnose delirium

26
Q

What is name given to more detailed cognitive assessment test

A

Montreal Cognitive Assessment

27
Q

Outated assessment test that is used much less

A

Mini Mental State Examination

28
Q

Changing nature of elderly population

A

Increased education of eldery people
Reduction of poverty
More people work for longer
More complex retirement process

29
Q

Challenges facing society from ageing population

A

Balance between working life/retirement
Healthy old age is extended
Have to care for older people- sanwich generation where have to care for older relative and raise children at same time
Outdated ageist beliefs
Medical system designed for single acute diseases

30
Q

Problems facing health care services

A

Increasing demand for all degrees of healthcare
Increasing complexity of disease
Navigating health and social care divide

31
Q

Ways to improve frailty

A

Exercise
Nutrition
Drugs

32
Q

Problems of multimorbidity

A 
Conditions and their treatments impact on one another
Negatives on patient
- worse QOL
- depressed
-functional impairment
- burden of treatment
- polypharmacy
33
Q

What is causing polypharmacy

A 
Multimorbidity
Guidelines for treatment
Non-adherence
Infrequent reviews
Lack of communication
34
Q

What is potentially inappropriate polypharmacy

A 
Up to 40% of prescriptions are inappropriate which can lead to bad outcomes
Falls
Increased length of stay
Delirium
Mortality
35
Q

What are normal changes to observe in older peoples cognitive ability

A

Slowed processing speed
Working memory reduced
Reduction in divided ability
Executive functions reduced

36
Q

What changes shouldnt be observed in cognitive ability

A

Nondeclarative memory
Visuospatial abilities
Lanuage

37
Q

Advantages of montreal cognitive assessment

A 
Variety of cognitive domains
Brief
Translated versions
Widely used
Validated widely
38
Q

Disadvantages of montreal cognitive assessment

A 
Education level a factor
Language level a factor
Can be carried out poorly
Possible coaching for it
Floor and ceiling effects

LCRS 1 (58 decks)

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