Ageing and Healthcare

Question 1

the molecular theory of ageing

Answer 1

• gene methylation
• histone modification e.g. by acetylation to regulate transcription of DNA and ‘spool’ DNA
• accumulation of mutations

genes can be amplified or suppressed

Question 2

theory of ageing - cellular

Answer 2

• telomere shortening so there is loss of chromosome caps
• free radical damage to DNA
• apoptosis - programmed cell death

Question 3

theory of ageing - environmental and evolutionary

Answer 3

• wear and tear = develop the inability ro regenerate damaged tissue
• cumulative uv and ionising radiation damage
• disposable soma = no evolutionary advantage to survival beyond reproduction and rearing children

Question 4

ageing population

Answer 4

60-75 predicted increase over the next decade or so

Question 5

as age increases…

Answer 5

so do the number of health conditions an individual has

- be aware that medications may be for symptoms or risk reduction

Question 6

what factors link disease to the deprivation index

Answer 6

• smoking
• alcohol
• diet and obesity
• housing

Question 7

what is the ‘holistic approach’ to medicine

Answer 7

trying to see the whole person, treating their physical, psychological, social, functional and well being

Question 8

frailty

Answer 8

a clinically recognisable state of increased vulnerability resulting from ageing associated decline in reserve and function across multiple physiologic systems such that the ability to cope with everyday or acute stressors is compromised

Question 9

phenotype of frailty

Answer 9

• unintentional weight loss
• reduced muscle strength
• reduces gait speed
• self supported exhaustion
• low energy expenditure

some people have additional issues of poor vision/hearing, low mood, cognitive impairment

Question 10

frailty scoring system

Answer 10

• edmonton frail scale - 9 aspects
• TUG test - timed up and go

walk three meters, and return to chair in less than 10 s

• Gait speed - 4m in >5 seconds