Frailty Flashcards
what is the frailty perspective?
- holistic perspective that shifts focus to a goal-directed approach
- must be considered when PCPs consider invasive procedures/harmful meds/high risk interventions
what do we mean by multi-morbidity?
> 3 chronic conditions
what makes something considered a geriatric syndrome?
syndromes associated with
- older age
- cognitive/functional impairment
- impaired mobility
highly prevalent, especially in frail elderly
chief complaint doesn’t represent specific pathological condition
cross organ systems and disipline-based boundaries
what are some examples or geriatric syndromes?
- incontinence
- falls
- pressure ulcers
- delirium
- functional decline
what poor outcomes come from geriatric syndromes and frailty?
- disability dependence
- nursing home
- death
in what populations is frailty more prevalent?
- women > men
- older age groups: 25-50% people over 85 estimated to be frail
- southern european, hispanic, african american
for what poor outcomes are the frail at risk?
increased vulnerability to stressors and poor health outcomes:
- acute illness
- procedural complications
- falls
- institutionalization
- disability
- death
how do we define frailty?
- a clinically recognizable state of increased vulnerability resulting from aging-associated decline in reserve and function across multiple physiologic systems
- further insult will result in: high potential for disability and disproportionate change in health status
what issues are there with defining frailty?
- multiple factors influence functional status and physiologic reserve
- age, multi-morbidity, and disability associated with frailty but do not establish the definition
- frailty transitions common
what are the 3 states of frailty?
- not-frail (robust)
- pre-frail
- frail
is frailty irreversible?
- no
- not an inevitable trajectory to death
- continuum not necessarily linear
what is the pathophysiology of frailty?
- cumulative, physiologic dysfunction that reaches an aggregate, critical level
- underlying genetic and environmental factors likely play a role
- physical activity and nutritional factors may be mediators
- disorder of several interrelated systems, including brain, endocrine, immune, and skeletal muscle
what is the key contributor to frailty?
sarcopenia
what is sarcopenia?
progressive, age-related loss of skeletal muscle mass, strength, and power
what are some other physiologic changes that contribute to frailty?
- deficiency in sex steroids, i.e. decreased estrogen in women and testosterone in men
- insulin resistance
- decrease in vitamin D
- increase in cortisol
- decreased growth factor