Multimorbidity, Frailty, & Complexity

Question 1

What is the most common pair of multi-morbidities? [2]

Answer 1

Cardiometabolic (BP, IHD, DM) and joint pain (eg OA)

Question 2

What is the most common triad of multi-morbidities? [3]

Answer 2

Commonest triad-cardiometabolic, joint pain and mental health (eg depression and/or anxiety)

Question 3

What does frailty arise from? [1]

Answer 3

Multiple body systems gradually lose their in-built reserves.

Question 4

Name 6 ways can assess frailty

Answer 4

E-Frailty Index (eFI)-embedded on common GP computer systems. Searches for 36 variables. (not a measure but a flag)

Timed Get Up and Go Test-walk 4m-taking 5 seconds or longer may indicate frailty (NICE NG56, 2016)

Do they have to stop to talk to walk? A predictor of frailty and falls (Lancet 1997;349:617)

QFrailty = QMortality and QAdmissions algorhythms-identify as low/mod/high levels frailty

Recognition of a Frailty Syndrome

Prisma 7

Rockford Score

Question 5

What are the prisma 7 questions? [7]
(probably dont need to know)

Answer 5

1] Are you more than 85 years?
2] Male?
3] In general do you have any health problems that require you to limit your activities
4] Do you need someone to help you on a regular basis?
5] In general do you have any health problems that require you to stay at home?
6] In case of need can you count on someone close to you?
7] Do you regularly use a stick, walker or wheelchair to get about?

Question 6

Describe the Rockford score [1]

When was it used? [1]

Answer 6

During COVID to determine if should be treated in HDU

Question 7

Where young-frailty patients more commonly found? [1]

Answer 7

Areas of deprivation

Risk factors may be different in younger adults than elderly population

Question 8

Name 5 factors that might make a patient more complex? [5]

Answer 8

Multimorbidity
Polypharmacy
Frailty
Social problems
Mental health problems
They never get better