Ageing and frailty (session 2 & 5)

Question 1

What are the different types of dementia? (to be considered in ICA unit)

Answer 1

Alzheimer's
Vascular
Mixed dementia
Lewy body
Frontotemporal/Pick's
Parkinson's disease

Question 2

Briefly describe Alzheimer’s dementia

Answer 2

Causes problems with memory, language and reasoning

Question 3

Briefly describe Vascular dementia

Answer 3

Impaired judgement, difficulty with motor skills and balance.
Risk factors: heart disease and strokes

Question 4

Briefly describe mixed dementia

Answer 4

Several types of dementia contribute to symptoms

Common in over 85s

Question 5

Briefly describe dementia with Lewy bodies

Answer 5

Can cause hallucinations and disordered sleep

Question 6

Briefly describe Picks disease

Answer 6

Personality changes and language problems.

Most common onset 45-60 yrs

Question 7

What is the biggest clinical problem with the elderly, especially those with dementia?
How is this tested?

Answer 7

Malnutrition

MUST tool

Question 8

What effect does ageing have on the respiratory system?

Answer 8

Lung and chest wall compliance decrease
TLC, FVC, FEV1 all reduce
Elastic support of airways is reduced, increasing collapsibility of alveoli and terminal conducting airways

Question 9

What respiratory system problems are common in the elderly?

Answer 9

Sleep apnoea

Post operative complications- atelectasis, PE, pneumonia

Question 10

What effect does ageing have on the skin?

Answer 10

Reduces collagen and elasticity
Thin skin
Fragile subcutaneous blood vessels

Question 11

What are the clinical impacts of the effects of ageing on the skin?

Answer 11

Lots of bruising
Achieving venous access can be difficult
Drugs to be wary of- warfarin, steroids, aspirin, statins

Question 12

What effect does ageing have on the CVS?

Answer 12

Less elasticity and compliance of blood vessels=raised systemic vascular resistance
Cardiac conducting cells decrease
Reduced ventricular contractility=reduced cardiac output

Question 13

What CVS problems are common in the elderly?

Answer 13

Hypertension= left ventricular strain and hypertrophy
Heart block, ectopic beats, arrhythmias, AF
Intravenous anaesthesia is achieved more slowly (arm-brain circulation time is increased by reduced CO)

Question 14

What effect does ageing have on the renal system?

Answer 14

GFR reduced

Renal perfusion reduced (due to reduced CO)

Question 15

What are the clinical implications of the effects of ageing on the renal system?

Answer 15

Diabetes mellitus is increasingly common
Nephrotoxic drug use is common (e.g. NSAIDs and ACEi)
Obstructive nephropathy in males is common
Dehydration is common esp during illness

Question 16

What effect does ageing have on the CNS?

Answer 16

Neuronal density is reduced

Question 17

What effect does ageing have on the endocrine and metabolic system?

Answer 17

Basal metabolic rate is reduced

Muscle mass is also reduced, causing impaired thermoregulatory control

Question 18

Briefly describe frailty

Answer 18

Ageing related physiological changes across multiple body systems, resulting in increased vulnerability to stressors

Question 19

What are some frailty presentations?

Answer 19

Immobility
Instability
Incontinence
Impaired memory
Vulnerable to iatrogenic harm

Question 20

What is CGA?

Answer 20

Comprehensive geriatric assessment

Allows a care plan to be generated, taking frailty into account