Frailty

Question 1

What is Frailty?

What is the Concept of Frailty?

What is the main component of Frailty syndrome?
→ What is this?

What does it increase the risk of after an injury?

Answer 1

• State of increased vulnerability due to poor homeostasis after stressor event, which increases the risk of adverse outcomes, e.g. falls, delirium, disability
• Practical, unifying notion in the care of elderly patients that directs attention away from organ-specific diagnoses towards a more holistic viewpoint (social, physical, mental effects) of the patient and their predicament
• SARCOPENIA
  → Loss of skeletal muscle mass and quality with ageing (loss of fast-twitch fibres)
• Delirium and Death

Question 2

DIAGNOSIS:
What is used to test grip strength?

What does Frailty present with?
→ How many of these have to be seen for a diagnosis?

What is the Comprehensive Geriatric Assessment (CGA)?

What is the Cumulative Deficit Model?

What is the Clinical Frailty Scale?

What’s the problem with using these scales?

Answer 2

• Dynamometer
• Unintentional weight loss, Reduced muscle strength, Reduced gait speed, Exhaustion, Sedentary behaviour
  → >3
• Talking through the physical, functional, psychological, and socioeconomic deficits the patients are facing and plan to put interventions in place
  o Very Effective Method
• 32 Baseline variable (e.g. signs, symptoms, disabilities), and a score is calculated
  o Electronic Frailty Index does the same thing essentially
• 9 explained categories
• People don’t necessarily fit into categories, time-consuming, they assess the patient when unwell, user variability, confounders

Question 3

MANAGEMENT:

What can be done?

Answer 3

• • Review Medication - Polypharmacy, Compliance, OTC medication
  • Review Falls - Assess potential causes for the falls and correct them
  • Advanced Care Planning - For severely frail patients, allow them to discuss what their priorities are