Ageing and Healthcare Flashcards
What are the 3 main factors which result in Evidence based Practice?
- Relevant Scientific Evidence
- Patient Values and Preferences
- Clinical Judgement
What are the diferent factors which make up the biological clock?
- Genetic/cellular
- Environemental
- Evolutionary theory
What factors are thought to contribute to ageing at the molecular level?
- Epigenetic modifications e.g gene methylation and histone modification/acetylation
- Age related “programmed” genetic regulation
- Cumulative random DNA damage
- Errors in gene expression or translation
What factors are though to contribute to cellular ageing?
- Telomere shortening-progressive loss of chromosome “caps”
- Free radical damage
- Apoptosis - programmed cell death
WHat are the facotrs which ncontribute to ageing at the enviromental and evolutionary level?
- “Wear and tear” i.e (in)ability to regenerate damaged tissue
- Cumulative UV and ionising radiation damage
- “Disposable soma” i.e. no evolutionary advantage in survival beyond reproduction and rearing children
What is the difference between absolute and relative risk reduction?
Someone’s chances of stroke decreases from 4% to 2% after taking a certain medication
- Absolute risk reduction = 2%
- Relative Risk Reduction = 50%
What is realistic medicine about?
- Holistic approach
- Involving the patient in decisions
- Health literacy e.g risks/benefits
- Decision making
- Potential for harm in over-or under-investigation and treatment
What is realistic medicine specifically NOT about (tries to avoid) / harmful stereotypes?
- Rationing
- Ageism
- Capping/control
- Party political ideas
- The “brave new world”
What does the holistic approach refer to?
- Trying to see the “whole person” ie physical, psychological, social, functional well being
- Particularly relevent in relation to elderly care (in community hospital/home/acute settings)
What should a comprehensive geriatric assement contain?
- Medicala and medication review
- Environmental hazards
- Functional capacity
- Psychological assessment
- Balance - assessment of falls risk
Give a definition of frailty?
A clinically recognizable state of increased vulnerability resulting from aging-associated decline in reserve and function across multiple physiological systems such that the ability to cope with everyday or acute stressors is comprised
What are the features of a frailty phenotype?
- Unintentional weight loss
- Reduced muscle strength
- Reduced gait speed
- Self-reported exhaustion
- Low energy expenditure
- Perhaps additional issues of poor vision/hearing, low mood, cognitive impairment
