Geriatrics 2 - comprehensive geriatric assessment

Question 1

2 main implications of an ageing world

Answer 1

multimorbidity

frailty

Question 2

Redundancy

Answer 2

progressive accumulation of damage leads to a complex system resulting in aggregate loss of system redundancy

Question 3

What 2 things does age related decline lead to?

Answer 3

impairment of organ function

dyshomeostasis

Question 4

Frailty

Answer 4

a reduced ability to withstand illness without loss of function

Question 5

How do we identify frailty?

Answer 5

frailty index 
fried et al - 3 of 5 criteria 
present with frailty syndrome eg immobility, delirium
HIS think frailty
clinical frailty scale from 1-9

Question 6

Fried et a criteria

Answer 6

exhaustion 
slow walking speed 
weak grip strength 
unintentional weight loss 
decrease physical activity

Question 7

HIS think frailty

Answer 7

Functional impairment 
Resident in care home 
Acute confusion 
Immobility or fall 
List of 6+ medications

Question 8

List the different health domains

Answer 8

medical - psychological - behavioural - nutritional - social - societal - environmental - spiritual - functional

Question 9

Comprehensive geriatric assessment

Answer 9

assess and manage illness in older people with frailty

determine the problems, what we can make better and a management plan

Question 10

spiritual health domain

Answer 10

meaning of life, what is important, self image

Question 11

psychological health domain

Answer 11

mood, confidence, cognition

Question 12

functional health domain

Answer 12

mobility, activity of daily life and community living skills

Question 13

behavioural health domain

Answer 13

eg unhealthy eating, smoking, occupation, activities

Question 14

What screening tool can be used for nutrition?

Answer 14

MUST

Question 15

Environmental health domain

Answer 15

housing, heating, sanitation

Question 16

social health domain

Answer 16

support networks, potential for abuse

Question 17

societal health domain

Answer 17

politics, attitudes to ageing, technology

Question 18

Hospital risks to the frail

Answer 18

learned dependency 
disorientation and delirium 
HAI 
iatrogenic harm 
deconditioning