Elderly- Ageing and Fragility

Question 1

What are some of the reasons why people are living longer?

Answer 1

• Increased resources availability
• Better economic conditions
• Improved screening programs with earlier diagnosis and treatment
• Better outcomes following major events: Cardiac, Stroke, Surgery

Question 2

What are the beneficial aspects of ageing?

Answer 2

Increased experiential learning

Question 3

What are the natural aspects of ageing?

Answer 3

Grey hair

Pastime preference

Question 4

What are the detrimental aspects of ageing?

Answer 4

Hypertension

Decreased reaction time

Question 5

What are the 3 theories of ageing?

Answer 5

• Stochastic
• Programmed
• Homeostatic failure

Question 6

What is Stochastic theory of ageing?

Answer 6

Ageing is due to cumulative damage and is random

Question 7

What is the programmed theory of ageing?

Answer 7

Ageing is Predetermined

Changes in gene expression during various stages

Question 8

How does ageing impact the kidneys?

Answer 8

There is a decrease in creatinine clearance (ml/min)

Question 9

How does ageing impact the heart?

Answer 9

Systolic BP increases, Diastolic BP decreases

Cardiac output decreases

Question 10

How does ageing impact the lungs?

Answer 10

Vital Capacity decreases

Question 11

What is dyshomeostasis due to?

Answer 11

Impaired function of any organ system makes maintaining homeostasis difficult, leading to Dyshomeostasis

Question 12

What is frailty in terms of dyshomeostasis?

Answer 12

Frailty is progressive dyshomeostasis

Question 13

What is Frailty?

Answer 13

A susceptibility state that leads to a person being more likely to lose function in the face of a given environmental challenge

Question 14

What are frailty syndromes?

Answer 14

• Falls
• Delirium
• Immobility
• Incontinence

Question 15

How does hyperthyroidism present in someone with frailty?

Answer 15

• Depression
• Cognitive impairment
• Muscle weakness
• Atrial fibrillation
• Heart failure
• Angina

Question 16

What are the practical implications of increased life expectancy?

Answer 16

Increasing number people with multiple medical conditions
Increased inter-individual variability in organ function and homeostatic reserve
Little evidence of drug efficacy and safety for patients over 80
Multiple medications

Question 17

Why is there little evidence of drug efficacy and safety for patients over 80?

Answer 17

Mainly young and middle aged test subjects

Question 18

What issues can arise with someone being put on multiple medications?

Answer 18

Drug-drug interactions

Adverse drug reactions

Question 19

How does normothermia differ in someone who is older?

Answer 19

No change in basal body temperature

Minor changes in circadian rhythm

Question 20

How does heat stress differ in someone older?

Answer 20

Recued sweat gland output
Reduced skin blood flow
Smaller increase in cardiac output
Less redistribution of blood flow from renal and splanchnic circulations

Question 21

How does cold stress differ in someone older?

Answer 21

Reduced peripheral vasoconstriction

Reduced metabolic heat production