Ageing Process and Assessment

Question 1

What are the 3 main components of comprehensive geriatric assessment?

Answer 1

Medical, psychological and functional capacity

Question 2

What causes ageing at the molecular level?

Answer 2

Random damage during cell replication

Question 3

List some factors that contribute to an increased rate of ageing

Answer 3

Inflammation
Poor diet
Lifestyle stress
Inactivity

Question 4

List molecular factors that contribute to ageing

Answer 4

Mutations
Cellular aggregates
Cellular loss, senescence
Protein crosslinks

Question 5

Deposition of which protein extracellularly causes Alzheimer’s?

Answer 5

Amyloid

Question 6

What is meant by “senescence”?

Answer 6

Defective apoptotic pathway, resulting in non-functioning cells taking up space

Question 7

At which part of a chromosome is the telomere located? What is the single motif sequence present in the telomere?

Answer 7

End part

TTAGGG (which forms a DNA loop)

Question 8

What happens to the telomere region of a chromosome during cell replication? How is this significant in ageing?

Answer 8

Progressively shortens with cell replication

Eventually becomes too short to sustain, leading to senescence

Question 9

What is meant by the Hayflick limit?

Answer 9

The number of times a human cell population will divide until cell division stops (limits ageing)

Question 10

Which protein enzyme complex can re-extend shortened telomeres?

Answer 10

Telomerase

Question 11

What are the 4 main cellular responses to damage?

Answer 11

Repair
Apoptosis
Senescence
Malignant transformation

Question 12

Describe the disposable soma hypothesis to explain why body cells don’t simply repair themselves all the time

Answer 12

Repair requires lots of energy and resources that is not feasible beyond when reproduction is successful (reduced reproductive cells as we age)

Question 13

What is the theory of antagonistic pleiotropy and ageing?

Answer 13

Genes may have a beneficial role in early life, but the same genes can cause harm in later life, contributing to senescence and death

Question 14

A minor illness (e.g. infection) will cause greater stress in an old patient compared to a young patient. True/False?

Answer 14

True

Also rarely return to true homeostasis

Question 15

What are the 2 main methods of assessing frailty?

Answer 15

Deficit accumulation

Phenotypic

Question 16

How does deficit accumulation scoring assess frailty?

Answer 16

Count how many body systems have deficit and divide by total no. of body systems

Question 17

How does phenotypic scoring assess frailty?

Answer 17

1 point each for:
Unintentional weight loss
Low grip strength
Exhaustion
Low physical activity
Slow walk speed
[score of 3 = frail]

Question 18

Define ageism

Answer 18

Unacceptable behaviour that occurs as a result of the belief that older people are of less value than younger people

Question 19

What is used instead of differential diagnoses in geriatrics?

Answer 19

A problem list used to make diagnoses

Question 20

What is particularly important to consider when assessing an elderly person?

Answer 20

Co-morbidities

Medicine review

Question 21

What should you consider when taking a history from a confused elderly person?

Answer 21

Collateral history from family/ carers

Question 22

In geriatrics, what are the common features of a problem list?

Answer 22

Poor mobility
Falls
Confusion
Frailty
Continence issues
Polypharmacy

Question 23

Atypically, how would an elderly person present with an MI?

Answer 23

No chest pain
Collapse
Delirium
Dizziness
SOB

Question 24

List 3 ways in which DNA macromolecules are damaged?

Answer 24

Ionising radiation
Reactive oxygen species (inc. diet)
Extrinsic toxins

Question 25

What are the main factors that contribute to the lifelong trajectory of health and disease?

Answer 25

Chance
Genetics
Environment
Lifestyle