Frailty | Ageing + The Body Flashcards
What is the physiological definition of frailty?
Clinically recognisable state of increasing vulnerability resulting from ageing - associated decline in reserve + function across multiple physiologic systems such that the ability too cope with everyday stressors is comprised
What is the phenotypic definition of frailty?
Low grip strength
Low energy
Slowed walking speed
Low physical activity
Unintentional weight loss
What are the 5 Is of geriatric giants?
- immobility
- instability
- incontinence
- impaired memory
- iatrogenesis
What is involved in intrinsic ageing?
- chronological ageing
- DNA damage
- biochemical degenerative process
- changes in cortisol + hormone levels
- telomere shortening
- oxidative stress
What is involved in extrinsic ageing?
- biochemical processes
- environment
- mechanical
- lifestyle
- behaviour
Skin changes related to age
- progressive structural + functional degeneration:
-atrophy of epidermis
-destruction to dermal-epidermal junctions
-dermis thickness decreases due to: collagen fragmentation + elastin degradation - prone to conditions + diseases
Respiratory changes related to age
- ^RV
- ^FRc
- v VC
- increased lung compliance but decreased elastic recoil
- infection susceptibility
- hyperinflation
CVS changes related to age
myocardial structural change:
- ventricular hypertrophy
- interventricular septal hypertrophy
- sympathetic innervation
- aortic sclerosis
.
myocardial functional change:
- diastolic dysfunction
- decreased CO
- decreased maximal HR
- increased cardiac workload
- baroreceptors response
.
electrophysiological:
- SAN atrophy
- prolonged AP
.
vascular changes:
- large arteries dilate
- artery walls thicken
GI changes related to age
- Decreased peristalsis > delayed transit time
- Decreased relaxation of lower oesophageal sphincter on swallowing
- atrophic gastritis
- decreased intestinal motility in colon > diverticulosis
Neurological changes related to age
- some parts of brain shrink (especially areas related to learning + complex mental activities)
- ventricular enlargement
- cortical thinning
- volume loss
- sulcal widening
Renal changes related to age
- decrease in volume + weight of kidneys
- decline in glomeruli number
- ^ urinary incontinence
- decline in tubular function > glucosuria > ^ UTI risk
Define malnutrition
State of nutrition in which a deficiency or excess of energy, protein + other nutrients cause measurable adverse effects on the body
Consequences of malnutrition
- impaired immune response
- reduced muscle strength
- inactivity
- loss of thermoregulation
- impaired wound healing
- impaired psycho-social function
Outline compassionate care for ageing
- patient centred approach: what do they want?
- advance care planning
- involved family/friends/carers
What can be used to assess frailty?
Clinical frailty scale
1-9
