Ageing and Frailty

Question 1

What is compression of morbidity?

Answer 1

Preventing the older life expectancy causing a protracted period of disability in the elderly

Question 1

What is a geriatric syndrome?

Answer 1

The accumulated effect of impairments in multiple domains that together result in a particular adverse outcome

Question 2

What is the definition of a disability?

Answer 2

A physical or mental impairment that limit 1 or more major ADLs

Question 3

T/F the reason we have more old people compared to in the past is because people are living to an greater age

Answer 3

False, it’s because more people are living out their life expectancy

Question 3

What are the healthcare implications of disability?

Answer 3

Rehab

Social integration and community services

Aim to decrease dependency

Potential for primary, secondary and tertiary prevention

Question 3

What are the “Giants of Geriatric Medicine”

Answer 3

Incontinence

Immobility

Impaired balance

Impaired cognition

Iatrogenic illness

Question 4

What is the difference between successful ageing and usual ageing?

Answer 4

Successful ageing refers to changes due solely to the ageing process, unaffected by disease, environmental or lifestyle factors whereas usual ageing refers to changes associated with the combined effects of the ageing process, disease and adverse environment and lifestyle factors

Question 5

What are the healthcare implications of co-morbidity?

Answer 5

The complexity of treating concurrent diseases

Potential for preventing diseases or minimising severity

Fragmentation of services

Minimise risk of disability and frailty

Question 6

What is the physiological state proposed to cause frailty?

Answer 6

Low-grade, chronic activation of the immune system with abnormalities of the endocrine and coagulation systems

Question 7

Why does sarcopenia occur?

Answer 7

Altered CNS and PNS innervation

Altered hormonal status

Inflammatory effect

Altered caloric and protein intake

Disuse

Question 8

What is frailty characteristed by?

Answer 8

Diminished ability to carry out the important practical and social activities of daily living

Excess demand imposed upon reduced capacity

Precarious balance easily perturbed

Risk of adverse health outcomes

Unable to integrate responses in the face of stress

Question 10

What is sarcopenia?

Answer 10

Ageing of skeletal muscle

Question 11

What is cellular senescence?

Answer 11

Phenomenon where cells lose their ability to divide

Question 12

What is co-morbidity?

Answer 12

The presence of > than 2 chronic diseases

Question 14

Which cytokines have been postulated to play a role in ageing?

Answer 14

IL6 and TNFalpha

Question 15

What are Fried’s criteria of frailty?

Answer 15

Unintentional weight loss

Weakness

Exhaustion

Slow walking speed

Low physical activity

Question 16

What are the effects of sarcopenia?

Answer 16

Change in gait

Loss of posture and balance

Question 17

Which type of muscle fibres are preferentially affected in ageing?

Answer 17

Type 2 fibres - fast twitch

Question 19

T/F the decline in reserve capacity for each organ is the same for different people

Answer 19

False, different people’s organs will decline at different rates

Question 20

What do cells do in response to DNA damage?

Answer 20

Senescence or apoptosis

Question 21

Why are more people living out their live expectancy?

Answer 21

Because there is less acquisition of disease due to better accommodation, sanitation, water, nutrition, maternal outcomes and use of vaccines