Ageing

Question 1

What is sarcopenia?

Answer 1

The reduction of skeletal muscle mass, strength and performance with age

Question 2

What does sarcopenia coexist with?

Answer 2

Frailty, multiple comorbidities, polypharmacy and falls

Question 3

How is sarcopenia diagnosed?

Answer 3

Slow gate (Less than 4m in 5 seconds)
Poor grip strength (

Question 4

Management of sarcopenia?

Answer 4

Progressive resistance exercise 2-3/week for at least 3 months
Regular increase in physical activity (walking)
Improved dietary intake (1-1.2g/kg body weight/day

Question 5

Primary sarcopenia is due to?

Answer 5

Age

1-2% muscle mass lost each year after 40

Question 6

Why is muscle lost each year after the age of 40?

Answer 6

Anabolic resistance, oxidative damage, decreased myofibre innervation

Question 7

Secondary sarcopenia is due to?

Answer 7

Reduced physical activity (eg bed rest, zero gravity)
Poor nutrition (eg inadequate dietary protein intake, malabsorption)
Disease related (malignancy, inflammatory disease, endocrine)

Question 8

Risk factors for 1º sarcopenia

Answer 8

Low birth weight
Poor growth during childhood and puberty
Obesity

Question 9

What is SARC-F?

Answer 9

Assessment tool for sarcopenia

Ability to carry a heavy load, walk, rise from a chair, climb stairs and assess fall frequency

Question 10

What is frailty?

Answer 10

A state of increased vulnerability to stressors due to reductions in physiologic reserve in multiple body systems.
Vulnerable to adverse health outcomes
Just about coping until ‘trivial infection’

Question 11

Signs and symptoms of frailty

Answer 11

Exhaustion
Weakness
Weight loss>5kg in year
Slow walking speed
Low physical activity

Question 12

What is the anorexia of ageing?

Answer 12

Decreased olfaction, increased satiety
Poor dentition, impaired gut function
Decreased access to food/functioning

Question 13

Interventions for frailty?

Answer 13

Dinner table, protected meal times
Feeding help and fortified food
Exercise and mobility (Tai Chi)

Question 14

Why are long lies important to pick up?

Answer 14

Urinary retention-> UTI
AKI
Rhabdomyolysis
Hypothermia
Pressure sores

Question 15

What is delerium?

Answer 15

Acute confusion secondary to a cause

Question 16

What is delerium defined by?

Answer 16

Disturbance of consciousness (decreased attention)
Change in cognition or perceptual disturbance (incoherent/disorganised thinking)
Acute (hours/days) and fluctuant
Evidence of a cause

Question 17

How common is delerium in intensive care and palliative care?

Answer 17

80% and 85%

Question 18

What needs to be assessed in delerious patients?

Answer 18

Baseline functioning from collateral history
Time course
Drug and medical history
Vital signs, hydration
Bitten tongue, signs of head injury, fractures
Autonomic innervation
Any cranial nerve palsies/motor deficits

Question 19

10 causes of delerium?

Answer 19

Drugs (opiates, polypharmacy)
Sensory deficits
Low PO2
Infection
Urinary/faecal retention
Ictal state
Underhydration/nutrition
Subdural haematoma
Pain
Glycaemic control