Ageing and Frailty

Question 1

Epidemiological factors of ageing population

Answer 1

Decreased fertility rates
Life expectancy increasing at birth - also ages 60,65 and 80 y/o
(-treatment?)

Question 2

Other population factors leading to ageing population

Answer 2

Resources
Economy
Screening
Better outcomes after major events - cardiac, stroke, surgery

Question 3

Disadvantage of an ageing population

Answer 3

Many comorbidities

Question 4

2 types of Ageing

Answer 4

Primary - eg. osteoarthritis

Secondary - eg. reduced mobility due to primary conditions

Question 5

Effects of ageing

Answer 5

Beneficial, neutral and detrimental

eg. HT, slower reaction time

Question 6

Theories of ageing

Answer 6

1. Stochastic - cumulative damage eg microtraumas to joints ; Random
2. Programmed - predetermined; changes in gene expression during various stages

AGEING LEADS TO HOMEOSTATIC FAILURE

Question 7

Ageing and Kidney function

Answer 7

Serum creatinine remains roughly the same
Clearance decreases, muscle mass decreases
Function decreases

Question 8

Dyshomeostasis

Answer 8

Impaired function, can’t maintain steady state

Question 9

Frailty

Answer 9

Progressive dyshomeostasis

Question 10

Susceptibility state

Answer 10

More likely to lose function in face of given environmental challenge

Question 11

Frailty Syndromes

Answer 11

Falls
Delirium
Immobility
Incontinence

Question 12

3 issues in Maintaining BP in elderly

Answer 12

1. Carotid Sensitivity
2. Medication: inhibit sympaythetic system
3. Heart unable to increase rate due to disease

Question 13

3 changes in Temperature Control in ageing

Answer 13

Normothermia - in frailty minor change in circadian rhythm
Cold stress - reduced peripheral vasoconstriction
Heat stress - less sweat - can’t increase - more likely to develop heat stroke

Question 14

Social dyshomeostasis

Answer 14

Contact
Work
Social groups
Family
Environmental stress- family on holiday, death of spouse, routine and background impairment

DIFFERENT ABILITY TO COMPENSATE –> DELIRIUM

Question 15

Hyperthyroidism - typical symptoms

Answer 15

Tremor
Anxiety
Weight loss
Diarrhoea

Question 16

Presentation of Hyperthyroidism with frailty

Answer 16

Depression
Cognitive impairment
Muscle weakness
Atrial Fibrillation
Heart Failure
Angina

Question 17

Complications of hyperthyroidism and frailty

Answer 17

Delirium
Falls
Loss of function

Question 18

Evidence gap

Answer 18

Conditions more common

Medication trials few