Dementia and Ageing

Question 1

Diagnostic factors of sarcopenia?

Answer 1

Decreased muscle mass (DXA)

Slow gait speed over 4m

Question 2

R/Fs for sarcopenia?

Answer 2

Increased age
Lack of exercise
High/low BMI
Inflammation
Low protein diet

Question 3

Sarcopenia management?

Answer 3

Exercise, dietary supplementation, Vit D

Question 4

Risks for falls in the elderly?

Answer 4

Sarcopenia
Dementia
Alcohol use
Low BP/postural hypotension
Infection

Question 5

Fall complications?

Answer 5

Fractures
Rhabdomyolysis - can lead to kidney failure
Head injury - delirium, bleed (any head injury on warfarin should have a head CT)

Question 6

Types of delirium?

Answer 6

Hypoactive delirium

Hyperactive delirium

Question 7

Forms of dementia?

Answer 7

Alzheimers

Vascular dementia (MMI dementia)

Lewy body dementia

Fronto temporal dementia

Question 8

Definition of sarcopenia?

Answer 8

Progressive generalised loss of skeletal muscle mass and strength with age

Question 9

Factors that account for the maintenance of muscle mass?

Answer 9

Anabolic hormones e.g. testosterone

Growth factors e.g. GH

Vit D

Physical activity

Question 10

Factors that account for the reduction in muscle mass in sarcopenia?

Answer 10

Catabolic hormones e.g. Glucagon, steroids

Inflammatory mediators e.g. cytokines

Obesity

Question 11

Changes to muscle tissue with age?

Answer 11

Decline in both muscle fibre size and number

Single muscle fibre intrinsic force is decreased

Question 12

Definition of frailty?

Answer 12

Increased vulnerability to stressors associated with a decline in physical and psychological reserves

Question 13

Consequences of sarcopenia?

Answer 13

Disability and poor mobility
Falls and fractures
Cardiovascular disease
Reduced quality of life
Hospital admission

Question 14

Features of a diet that may prevent sarcopenia?

Answer 14

Higher antioxidant status

High Fish oil consumption

Greater fruit and vegetables

Question 15

Pharmacotherapy for sarcopenia?

Answer 15

GH

Testosterone (maybe)

ACE (maybe)

Question 16

Way to remember causes of delirium?

Answer 16

DELIRIUM(S)

Drugs
Eyes/ears
Low O2
Infection
Retention
Ictal state (seizure)
Undernourished/underhydrated
Metabolic
Subdural haematoma

Question 17

Pharmacological choices for delirium management?

Answer 17

Haloperidol
olanzipine
Benzos
Cholinesterase inhibitors