geriatrics: ageing and frailty Flashcards
what is fraility?
progressive dyshomeostasis
(reduction in ability to deal with an environmental challenge)
frailty results in ‘frailty syndromes’, what are these?
- Falls
- Delirium
- Immobility
- Incontinence
how is the average age of the population changing?
ongoing demographic shift
population of world is getting older (developed and developing world):
- Fertility rates falling
- Life expectancy increasing
- Therefore aging population
why is life expectancy increasing?
- increased resources
- better economic conditions
- improved screening with earlier diagnosis and treatment
- better outcomes following major events
- cardiac, stroke, surgery
what are the different theories of ageing?
stochastric theory: random, accumulate damage due to micro damage and free radicals which builds over time
programmed: predetermined, changes in gene expression during various stages
these things cause homeostatic failure, less reserve to deal with damage
what are examples of physiological changes in ageing?
affects every organ system, affecting individuals differently:
renal: GFR falls
CVS: BP increases (systolic increases but diastolic falls), CO falls
respiratory: vital capacity decreases
how do the following change in ageing:
- GFR
- BP
- CO
- vital capacity
GFR - falls
BP - increases (systolic increases but diastolic decreases)
CO - falls
vital capacity - decreases
what are examples of reduced homeostasis in the elderly?
reduced baroreceptor reflex for low blood pressure
cold stress: less peripheral vasoconstriction and metabolic heat production
heat stress: reduced sweat gland output, reduced skin blood flow, smaller increase in CO, less redistribution of blood from renal and splanchnic circulations
are clinical features the same in the old and young?
medical conditions might have different presenting signs and symptoms in people with frailty
what is known about drug efficacy and safety for patients 80+?
little evidence on drug efficacy and safety for patients 80+
