ageing and frailty Flashcards
geriatric medicine
concerned with people w frailty
demographic shift
population getting older - people living longer
birth rate falling
why are people living longer
more resources available
better economic conditions
better screening
better outcomes following major events - cardiac, stroke
consequences of people living longer
more survival from major events - more disability
more co-morbid presentation
theories of why we get old
stochastic: cumulative damage - microtrauma, free radicals
programmed: predetermined to die, changes in gene expression during various stages
homeostatic failure: result of above, less reserve to cope with environmental challenges, less able to maintain homeostasis
ageing and kidneys
clearance of creatinine becomes poorer - reduction in muscle bulk
ageing and CVS
systolic BP goes up and beyond 60 diastolic goes down (hard to treat systolic HTN without lowering diastolic too much)
CO decreases
ageing and resp system
total lung capacity stays same but vital capacity decreases
dyshomeostasis
frailty is essentially progressive dyshomeostasis
progressive reduction in ability to deal with environmental challenge
frailty
susceptibility state that leads to person being more likely to lose function in the face of a given environmental challenge
frailty syndromes
falls: reduced ability to maintain balance
delirium: reduced concentrate/ability
immobility
incontinence
presenting features of someone with frailty leads to
falls
immobility
delirium
incontinence
multiple medications risk
drug-drug interactions
adverse drug reactions
frailty criteria: 3 of
unintentional weight loss exhaustion slow walking speed low physical activity weak grip strengh
ADLs
transfers mobility meal preparation feeding washing dressing
