Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Royal College 2023 > Frailty > Flashcards

Frailty Flashcards

You may prefer our related Brainscape-certified flashcards:
Royal College: Emergency Medicine flashcards
1
Q

What is phenotypic frailty vs. index frailty?

A

Phenotypic (physical) = due to dysregulation of physiologic processes causing vulnerability to adverse health outcomes

Index (cumulative deficit) = accumulation from a number of disease, impairments and other health conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

What is the Fried definition of frailty?

A

A biologic syndrome due to
Cumulative declines across multiple physiologic systems
Leading to decreased reserve and resistance to stressors
Causing vulnerability to adverse outcomes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are 5 characteristics of phenotypic frailty (Fried)?

A
  1. Shrinking - weight loss >10 lb 1 year or >5% body weight
  2. Weakness - grip strength lowest 20%
  3. Poor endurance/exhaustion - self reported questionnaire
  4. Slowness - gait speed lowest 20%
  5. Low activity - self report questionnaire
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are three instruments for measuring frailty?

A
  1. Physical frailty phenotype (Fried)
  2. Deficit Accumulation Index (Frailty Index)
  3. Clinical Frailty Scale (Rockwood)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Why are frailty instruments limited?

A
  1. Need to study validity
  2. Need to study feasibility
  3. No validated for clinical decision making or interventional target
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

SPRINTT results - effect of moderate intensity exercise and personalized nutrition counselling on mobility disability

A

Baseline SPPB score 3-7 (more frail)
Less incidence of mobility disability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are 6 interventions to reduce frailty or prevent progression?

A
  1. Exercise (Strength, resistance)
  2. Nutrition (protein, calorie)
  3. Medication review
  4. Social engagement/supports
  5. Target sensory deficits
  6. CGA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

List 9 nutritional deficits that may be associated with frailty?

A

Vit B12
Vit C
Vit D
Vit E
Folate
Carotenoids
Insufficient protein intake
Poor quality diet
Low antioxidant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What was the main finding of the DELIVER trail re: worsening CHF events or CVD death

A

Dapagliflozin decrease risk of primary end point

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What did the DELIVER study find about the impact of dapagliflozin for more frail patients?

A

Associated with greater symptomatic improvement for more frail patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

In the DELIVER trial, compared with less frail pts what did the study find re: ADRs and treatment discontinuation for more frail pts?

A

ADRs and treatment discontinuation were not more common with dapagliflozin than placebo, irrespective of frailty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the CFS for bed bound, dependent all ADLs?

A

CFS 7 = Severe frailty
? 8 - may die within 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

CFS?
84 yo, home with wife, MNCD, uses cane, wife does IADLs, independent BADLs

A

CFS 5 = mild frailty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

CFS?
87 yo M, PD, assistance with bathing and dressing, eats independent

A

CFS 6 = moderate frailty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Fried frailty scale pro and con

A

Pro: independently predicts falls, hospitalizations, disability and death
Con: doesn’t include psychosocial components of frailty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pro and con of Frailty Index (DAI)

A

Pro: proxy for ageing and mortality, reflects severity of illness and proximity to death
Con: very difficult to use in clinical setting, need to ID all possible relevant health deficits and track

16
Q

Clinical frailty scale pro and con

A

Pro: predicts death and need for institutionalization within 5 years
Con: requires judgement, best performed by physicians caring for the elderly

17
Q

Edmonton frailty scale pro and con

A

Pro: includes social support domain suggesting dynamic model
Con: not validated in non-English, vision/hearing/blind

18
Q

What 4 quick physical performance measures are independently predictive of mortality?

A
  1. Grip strength
  2. Walking speed <0.8 m/s
  3. Chair rise time
  4. Standing balance
19
Q

List 9 risk factors for frailty.

A
  1. Advanced age
  2. Female
  3. Low SES
  4. Chronic diseases
  5. Malnutrition
  6. Impaired cognition
  7. Polypharmacy
  8. Physical inactivity
  9. Smoking/alcohol
20
Q

4 precipitating factors shared by all three of delirium, fall and urinary incontinence

A
  1. Anticholinergic medication
  2. Alcohol intoxication
  3. UTI
  4. Dementia
21
Q

What are the three frailty criterion on the SPPB and how is each scored?

A
  1. Gait speed - 4 m course at usual speed
  2. Repeated chair stands - attempt to rise from chair.5 times without using arms
  3. Standing balance - side by side, semi tandem, tandem stand each for 10 seconds
22
Q

What patient populations were excluded from the study that informed the Fried frailty phenotype?

A

Parkinson’s disease
Stroke
MMSE <18
Patient on Sinemet, Aricept or anti depressants

Royal College 2023 (79 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions