Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Geriatrics > Ger 8 Fraility > Flashcards

Ger 8 Fraility Flashcards

1
Q

What does the phenotype of frailty develop as a consequence of?

A

Decline in several physiological systems which collectively results in a vulnerability to sudden health state changes triggered by relatively minor stressor events

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is fundamental to the development of frailty?

A

Age-related changes to multiple physiological systems (especially neuromuscular, neuroendocrine, and immunological)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What interacts cumulatively and detrimentally resulting in a decline in physiological function an reserve?

A

Age-related changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What happens when a cumulative threshold of changes is reached?

A

The ability of an individual to resist minor stressors and maintain physiological homeostasis is compromised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What can the loss of functional homeostatic reserve at the level of individual physiological systems ultimately do?

A

Adversely affect the whole person

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What can be done on the basis of the resulting frailty phenotype?

A

Identify older people who are frail

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are frail people predisposed to?

A

Adverse health consequences (falls and delirium) following relatively minor stressor events

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is included in the frailty phenotype?

A
  1. Sarcopenia: Loss of muscle mass and strength
  2. Anorexia
  3. Osteoporosis
  4. Fatigue
  5. Risk of falls
  6. Poor physical health
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does the addition of a minor stressor event to a frail older person with impairment of balance or cognition explain?

A

The clinical syndromes of falls and delirium (respectively), as common consequences of frailty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why do healthcare systems struggle to cope adequately with the common presentations of ill health in older people who are frail?

A

Mainly because their healthcare states change suddenly and unpredictable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What has been demonstrated to optimize outcomes for older people with frailty?

A

Comprehensive geriatric assessment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the frailty cycle or spiral?

A

Increasing frailty gives rise to increased risk of further decline towards disability and greater frailty (look at figure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What can happen to a person who is functionally independent, but through the combined processes of aging, chronic diseases, and deconditioning is super close to a theoretical line of decompensation?

A

A small additional deterioration caused by a minor stressor event (usually a urinary infection, new medication prescription, ect.) results in a sudden and disproportionately severe heath state change from one of independence to one of dependence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a key component of frailty?

A

Sarcopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is sarcopenia?

A

Progressive loss of skeletal muscle mass and strength

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When can the syndrome of sarcopenia result?

A

When there is loss of physiological reserve in the neuromuscular system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is proposed to contribute to the development of sarcopenia?

A

A complex relationship between muscle fiber loss, muscle fiber atrophy and multiple contributory factors (nutritional, hormonal, metabolic, immunological)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What % of loss in muscle strength per year has been reported in older people via observational studies?

A

1-3%

-Even higher in the oldest old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What can the development of sarcopenia adversly affect?

A

The ability of an older person to remain functionally independent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is required for the critical basic mobility skills of getting out of bed, standing up from a chair, walking a short distance, and getting off of the toilet?

A

Muscle strenth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What happens when the ability to perform critical skills is impaired?

A

An older person is at risk of becoming dependent for care needs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the 5 indicators of frailty according to the Fried model?

A
  1. Weight loss
  2. Exhaustion
  3. Low energy expenditure
  4. Slowness
  5. Weakness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the measure for weight loss?

A

Self reported weight loss of 4.5 kg or recorded weight loss of over 5% per year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the measure for exhaustion?

A

Self-reported exhaustion on a CES-D scale (3-4 days per week or most of the time)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the measure for low energy expenditure?

A

Under 383Kcal/week in a man or under 270Kcal/week in a woman

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the measure for slowness?

A

Standarized cut-off times to walk 15 feet, stratified for sex and height

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the measure for weakness?

A

Grip strength, stratified by sex and BMI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What happens when the identified 5 key components are present in combination?

A

They have the potential to interact and cause a “critical mass” that compromises the frailty syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Are the individual items in the Fried model of frailty identifiable to clinicians?

A

YES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the precise and objective measurement of the 5 domains appropriate to?

A

Research studies… too complex for routine clinical care

31
Q

What characterizes a robust older person?

A

People with none of the 5 indicators

32
Q

What happens when a person has one or two indicators?

A

They are hypothesized to compromise and intermediate or pre-frail group

33
Q

When is someone considered frail?

A

When they have 3 or more indicators

34
Q

Why is there some uncertainty about the relationship between frailty, cognitive impairment, and dementia?

A

Because older people who scored less than 18 on the Mini-Mental State examination (with moderate/severe cognitive impairment) were excluded from the cohort in which the Fried model of frailty was developed

35
Q

What is a diagnostic tool designed to identify frail older people in clinical settings that requires less than 5 mintues to administer and is valid and reliable when performed by a non-specialist?

A

The Edmonton frail scale (EFS)

36
Q

What has the reported EFS been developed to more recently measure?

A

Frailty in an acute hospital inpatient setting

37
Q

What were the frailty prevalence rates found for men and women in the UK study presented?

A

Women: 8.5%
Men: 4.1%

38
Q

Based on the US study presented, what was the frailty prevalence of men and women 65+?

A

6.9%

39
Q

What was the prevalence of frailty for the age groups
65-70
75-79
85-89?

A
  1. 2%
  2. 5%
  3. 7%
    * Frailty increased with age
40
Q

What was the 3 year frailty incidence rate found in the US study?

A

7%, with a further 7% between years 4 and 7

41
Q

What is frailty associated with?

A

Important adverse health consequences

42
Q

Older people defined as being frail on the basis of the Fried criteria were at significantly increased risk of what?

A

Disability, hospitalization, death

43
Q

What is the relationship between frailty, disability, and comorbidity?

A

Complex

44
Q

What is comorbidity defined as?

A

2 or more chronic diseases

45
Q

Do frailty, disability, and comorbidity exhibit significant overlap?

A

Yes, they are closely related

46
Q

Are frailty, disability, and comorbidiy synonymous?

A

NO

47
Q

If it possible that an individual may be phenotypically and measurable frail (frailty develops with multisystem physiological decline) in the absence of cormorbidity?

A

YES

48
Q

What can add further complexity to the situation?

A

The effects of single severe disease, presence of subclinical disease, or the presence of undiagnosed disease

49
Q

What can be measured using standardized instruments that assess activities of daily living (like the Barthel index)?

A

Disability

50
Q

How can disability develop?

A
  1. Progressively (from frailty)

2. Catastrophically (result of a stroke or hip fracture)

51
Q

What % of disability develops in older age progressively?, catastrophically?

A

50%, 50%

52
Q

What is likely to be significant to the development of disability in older age?

A

The contribution of physiological fraitly

53
Q

What does the association between frailty and adverse health outcomes carry?

A

Significant health resource implications

54
Q

What are reductions in the prevalence or severity of frailty likely to have large benefits for?

A

The individual, family, and society

55
Q

What are natural targets for treatment of frailty?

A

Sarcopenia and chronic undernutrition

56
Q

What has been successful at improving muscle strength and functional abilities in frail people?

A

Interventions involving strength and balance training

57
Q

What did one study conclude regarding physical rehabilitation for older people in permanent long-term care (frail population)?

A

There is good evidence that individual or group exercise programs are both acceptable and effective in improving mobility and other daily living tasks in this vulnerable population

58
Q

Where else has physical activity interventions targeted at improving the functional status of frail older people been successful?

A

For people living in the community

59
Q

True or False: When combined with physical activity interventions, nutritional supplementation doesn’t appear to be independently effective at improving functional abilities of frail older people compared to just physical activity interventions?

A

TRUE

60
Q

So are nutritional interventions effective?

A

Not so much

61
Q

What pharmacological agents have actions and effects with the potential to limit the development and progression of frailty?

A

Anabolic steroids, statins, ACEi, ect.

62
Q

Has evidence of a beneficial effect from pharmacological agents been reliably demonstrated?

A

No

63
Q

What is an important and common clinical condition associated with significant adverse health outcomes, including the development of disability in older age with its attendant personal and societal costs?

A

FRAILTY

64
Q

What are common manifestations of frailty?

A

Falls and delirium

65
Q

What has the potential to prevent disability in older age, and thereby the potential to improve general health and well-being?

A

Physical activity interventions that limit the progression of frailty

66
Q

What is frailty?

A

An important and common clinical condition characterized by a vulnerability to heath state change following minor stressor events

67
Q

What is fundamental to the development of frailty?

A

Age-related changes to multiple physiological systems

68
Q

What are identifiable characteristics of the frailty phenotype?

A

Sarcopenia (loss of muscle mass and strength), anorexia, osteoporosis, fatigue, risk of falls, and poor physical health

69
Q

What is frailty associated with?

A

Important adverse health outcomes, including increase in the risks of disability in older age and of admission to long-term care and increased mortality

70
Q

What do interventions that limit the progression of frailty have the potential to prevent?

A

Disability in older age, and thereby the potential to improve general health and well-being

71
Q

What 3 outcomes do people with frailty have increased risk of?

A
  1. Worsening ADL/disability
  2. Hospitalization
  3. Death
72
Q

What is categorized as no frailty?

A

None of the 5 operationalized Fried criteria for frailty

73
Q

What is intermediate frailty?

A

1 or 2 criteria for frailty

74
Q

What is frail?

A

3 or more criteria for fraitly

Geriatrics (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions