5.1 Frailty

Question 1

What is frailty?

Answer 1

Increased state of vulnerability, decreased physiological reserve, ability to cope with acute stressors is compromised

Question 2

What is the phenotypic definition?

Answer 2

Low grip strength
Low energy
Slowed walking speed
Low physical activity
Unintentional weight loss

Question 3

How is frailty graded?

Answer 3

1-9
1- very fit
9 terminally ill

Question 4

What are geriatric giants?

Answer 4

Happens to older people when they are unwell

Immobility
Instability
Incontinence
Impaired memory
Iatrogenesis

Question 5

Why are non-specific presentations relevent?

Answer 5

Frail older people will present with unusal symptoms

Not classic symptoms of common illnesses, harder to diagnose

Question 6

What is physiological decompensation?

Answer 6

Fit young people have a high physiological reserve, decompensation only occurs in severe illness

Older people have a lower physiological reserve, decompensation occurs far more easily, ergo more susceptible

Frail people unable to recover back to inital baseline

Question 7

What do you need to consider alongside frailty?

Answer 7

Polypharmacy
Co-morbidities

Need to balance pros and cons as to what drugs can be given

Question 8

What side effects are there in many drugs?

Answer 8

Anticholinergic effects, drowsiness, low blood pressure, low blood glucose
Opposite to sludge

Opposite of this :
Salivation
Lacrimation
Urination
Diarrhoea
GI pain
Emesis

Higher risk with polypharmcy

Question 9

What are ReSPECT forms?

Answer 9

Preferences of what the patient wants prioritised end of life

Comfort or life

Question 10

What is a comprehensive geriatric assessment (CGA)?

Answer 10

Process to determine :
- Medical
- Psychological
- Functional capabilites

of a frail older person to develop a coordinated and integrated plan for treatment and long-term follow-up