Frailty

Question 1

Why are there more old people

How many old people will there be by 2050

Answer 1

Increases in resources, better living conditions, improved screening programs, better outcomes following major health events such as stroke, surgery, heart attacks.

2 billion over 60’s by 2050

Question 2

What is stochastic theory of ageing

Answer 2

Cumulative damage occurs to the body in a random manner leading to a decrease in health

Question 3

What is the programmed theory of ageing

Answer 3

Predetermined failure of the body determined by changes in gene expression at various stages

Question 4

How are the kidneys affected with age

Answer 4

Rapidly decreases, creatinine clearance decreases by 4 fold in men and 3 fold in woman

Question 5

How does blood pressure change with age?

Answer 5

Systolic blood pressure increaes rapidly in those of an older age, average systolic is 140-150 in those over 80. Diastolic blood pressure decreases past 60, increasing the pule pressure in those over 60.

Question 6

Why does blood pressure change with age?

Answer 6

Blood pressure is lowered in response in increasing blood pressure
Pressure sensitive receptor in the carotid detects these changes and sends messages to the brain.
Activates sympathetic system to increase cardiac output increasing blood pressure

Question 7

How does cardiac output change with age?

Answer 7

Decreases

Question 8

How does lung capacity change with age?

Answer 8

Residual volume increases,
expiatory volume decreases,
inspiratory reserve volume slightly decreases with age

Question 9

How does ability to control temperature change?

Answer 9

Circadian rhythm decreases,
sweat gland output decreases,
blood flow to skin decreases,
cardiac output increases in response to heat,
blood flow is redistributed from the kidneys and splachnic centres.
Reduced peripheral vasoconstriction and metabolic heat production

Question 10

What s frailty

Answer 10

Progressive dyshomeostasis. Susceptibility of an individual to become more likely to lose function in the face of given environmental factors. This results in frailty syndromes such as falls, delirium, immobility or incontinence.

Question 11

What are the classic symptoms of hyperthyroidism?

Answer 11

Tremor
anxiety
weight loss
diarrhoea

Question 12

What are the symptoms of hyperthyroidism in the elderly

Answer 12

Depression,
cognitive impairment,
muscle weakness,
A fib, 
heart failure, 
angina

Question 13

Whats worrying about elderly and drugs

Answer 13

They take the most of them however there is limited research to show how it effects them. e.g. bisoprolol not shown to have any change in adverse outcomes

Question 14

How many elderly people do drugs?

Answer 14

98%,

36% take more than 5 medications

Question 15

How do adverse drug reactions effect the elderly

Answer 15

Increased with the more medications you take. e.g. 4% adverse reactions with 5 drugs take
11-15 drugs 24% ADR
21 or more drugs 45% ADR

Question 16

Summarise frailty in the ageing population

Answer 16

More patients to treat
Increase multiple organ involvement
Varying presentations of symptoms and signs
Very little evidence for those over 80
multiple medications cause ADR's