Assessment of frailty

Question 1

Define frailty?

Answer 1

State of increased vulnerability due to age associated decline in reserve and function across multiple systems
Ability to cope with acute stressors is compromised

Question 2

5 important markers of frailty?

Answer 2

Reduced muscle strength
Fatigue
Reduced walking gait
Unintentional weight loss
Sarcopenia

Question 3

4 means of measuring frailty?

Answer 3

PRISMA 7 Questionnaire
Time-up-and-go
Polypharmacy of 5 or more drugs
Comprehensive Geriatric Assessment

Question 4

7 questions on the PRISMA 7 questionnaire?

Answer 4

age 85?
Male?
Any health problems that limit your activities?
Do you need someone to help you on a regular basis?
Do you have any health problems which require you to stay at home?
Can you count on someone close to you?
Walking aid or wheelchair?

Question 5

During a comprehensive geriatric assessment, what is it important to compare your findings with?

Answer 5

Baseline function

Question 6

9 aspects of physical health that are investigated in a comprehensive geriatric assessment?

Answer 6

Medical diagnosis
Medications
Nutrition
Swallow
Vision
Hearing
Bladder
Bowel
Skin

Question 7

What other aspects of the comprehensive geriatric assessment are looked into alongside physical health?

Answer 7

Mental Health - cognition, mood
Functional status - ADLs, mobility
Social functioning - carer, family
Environment - home adaptations

Question 8

Aspects that change in the history taking of a geriatric patient in comparison to a younger patient?

Answer 8

Collateral history
Systemic questioning required
family history not really important

Question 9

4 main aspects of a mental state examination in geriatrics?

Answer 9

Consciousness
Behaviour
Intellectual function and memory
Mood

Question 10

How do you assess consciousness?

Answer 10

AVPU

Question 11

How do you assess behaviour?

Answer 11

How do they spend their time?
Has their behaviour changed? - collateral
Hallucinations?
Physical appearance

Question 12

What is the mini test performed to assess someones intellectual functionning and memory?

Answer 12

Age
Time
Address to remember

Year
Hospital
Name 2 people
Date of birth
Year of WW1
Name of prime minister
Count backwards from 20

Question 13

Why is mental capacity important to consider in functional assessment?

Answer 13

They may have the functional ability to carry out tasks but not the mental capacity or too confused, poorly motivated

Question 14

10 points looked at on Barthel ADL

Answer 14

Bathing
Bowels
Bladder
Toilet
Transfer
Mobility
Stairs
Dressing
Grooming
Feeding

Question 15

What is it important to take into consideration with a Barthel ADL index?

Answer 15

Comparison with previous levels of functioning

Question 16

What do you look at in a social assessment and environment?

Answer 16

Assess the house
Assess any accident hazards
Assess the care of the house - who does the cleaning? shopping? cooking? where are the shops?
Assess care of the person
Are there any carers
Social support
Supporting services