Frailty in Old People

Question 1

Define frailty.

Answer 1

Conditions characterised by loss of biological reserves and vulnerability to adverse outcomes causing falls.

Question 2

How can you measure frailty?

Answer 2

1. Frailty index score (number of deficits in an individual/total number of deficits measured).
2. Clinical frailty score.

Question 3

What are the important considerations to make in frailty?

Answer 3

Frailty increases the length of stay, end of life care consideration, readmissions are high, the fact older people have non-specific presentations of diseases and that there is an increase risk of complications

Question 4

What pathological presentations are typical in frail older people?

Answer 4

1. Cognitive impairment.
2. Iatrogenesis.
3. Deafness and blindness.
4. Axial osteoarthritis.
5. Vascular disease.
6. Diabetes mellitus.
7. Respiratory diseases.
8. Depression.

Question 5

Describe the problems with homeostasis and elderly frail patients.

Answer 5

Homeostasis involves systems to balance temp, BP, Na. This can fail due to an overwhelming single disease/lesser disease with multiple co-morbidities.

Question 6

What is the problem of differential challenge in frail elderly patients?

Answer 6

The idea that a frail patient is not just at risk of homeostatic dysfunction from disease but due to their circumstance such as poverty, lack of ability to pay heating bill and social isolation.

Question 7

What is the comprehensive geriatric assessment toolkit?

Answer 7

Used to integrate into personalised care planning to assess, create a list of problems, forming a personal care plan with interventions and a regular planned review.
It is completed when a patient has one or more of a frailty syndrome. It can be done in the GP or nursing home.