Elderly Ageing and Frailty

Question 1

Name 4 reasons for an ageing population

Answer 1

1. Increased resources availability
2. Better economic conditions
3. Improved screening programs with earlier diagnosis and treatment
4. Better outcomes following major events (e.g. Cardiac, Stroke, Surgery)

Question 2

Give 2 consequences of an ageing population

Answer 2

1. As more people are surviving major events, more people are being left with adverse effects from it
2. More individuals have several co-morbidities

Question 3

What are the changes in survival due to

Answer 3

Selective survival

Cohort effects

Question 4

What 2 types of ageing are there and explain

Answer 4

Primary - Due to biological ageing (e.g. osteoarthritis)

Secondary - Due to primary ageing (e.g. getting slower due to arthritis)

Question 5

What can ageing be (3)

Answer 5

1. Beneficial
Increased experiential learning
2. Natural 
Grey hair
Pastime preference
3. Detrimental 
Hypertension
Decreased reaction time

Question 6

State the 3 theories of ageing

Answer 6

1. Stochastic
   a) Cumulative damage such as oxidative stress or microtrauma to joints
   b) Random - Cells dying off
   If you could prevent these changes the you could stay young
2. Programmed
   This is predetermined, there are changes in gene expression during various stages
3. Homeostatic

Question 7

What happens to serum creatinine while ageing

Answer 7

Decreases

Question 8

What happens to BP while ageing

Answer 8

Systolic - Increases

Diastolic - Peaks at 60 then decreases

Question 9

What is dyshomeostasis

Answer 9

Difficulty in maintaining homeostasis

Question 10

What is frailty

Answer 10

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

Question 11

What are the four indications of frailty syndromes

Answer 11

Falls
Delirium
Immobility
Incontinence

Question 12

What is social dyshomeostasis

Answer 12

This is difficulty caused by environmental insults not only bio-medical
These people will have a different ability to compensate for e.g. death of spouse or daughter going on holiday.

Question 13

What is the classic presentation for hyperthyroidism (4)

Answer 13

Tremor
Anxiety
Weight loss
Diarrhoea

Question 14

How can a frail individual present with hyperthyroidism (10)

Answer 14

Depression
Cognitive impairment
Muscle weakness
Atrial fibrillation
Heart failure
Angina
Falls
Delirium
Immobility
Incontinence