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Flashcards in Ageing and frailty Deck (21):

How will Australian population have changed in 20 years time?

Ageing population

Many more people above the ages of 65 and 80

Increased pressure on healthcare services


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Briefly describe factors that have led to the compression of mortality over time?


Many medical factors: immunisation, combatting childbirht mortality

Many environmental factors: altering the resources available, conditions in which people live


Describe why compression of morbidity is just as important as compression of mortality?

Don't want people living longer with disabilities and poor health outcomes

So, need to delay onset of disability as well as mortality 

Quality of life vs quantity of life 


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Define ageing?

Total of all changes an organism undergoes from conception to death


Define cellular and organismal senescence?

Cellular senescence: phenomenon where cells lose their ability to divide

Organismal senescence: the ageing of whole organisms


How can disease and deconditioning affect ageing?

Accelerate the ageing process


Describe how we cope with responding to challenges during ageing?

Decreased reserve to respond to challenges


Describe the difference between successful ageing and usual ageing?

Successful ageing: changes due solely to the ageing process, unaffected by disease, environmental or lifestyle factors

Usual ageing: changes associated with the combined effects of the ageing process, disease and adverse environment and lifestlye factors


What is frailty?

Concept only

Distinct clinical syndrome with underlying biological processes that are not yet well understood



Which biomarkers are associated with frailty?

Frailty is associtaed with chronic, low-grade activation of the immune system

So, biomarkers such as IL6, TNFa and CRP are associated with frailty 


Describe the factors which contribute to the development of sarcopenia?

Altered CNS and PNS innervation

Altered hormonal status

Inflammatory effects

Altered caloric and protein intake



Describe the effect of sarcopenia?

Decline in strength of muscles, especially limbs

Huge muscle loss and weakness


Which muscle fibres are most affected by sarcopenia?

Type 2 fibre loss > Type 1 fibre loss

(Type 2 = fast twitch)


Describe Fried's criteria for diagnosing frailty?

1) Unintentional weight loss

2) Weakness

3) Exhaustion

4) Slow walking speed

5) Low physical activity


Pre-frail: 1-2 criteria

Frail: >3 criteria


Describe the difference between co-morbidity, disability and frailty?

How do they overlap?

Co-morbidity: concurrent presence of 2 or more chronic diseases (refers to how many chronic diseases a person has)

Disability: physical or mental impairment that limits 1 or more major ADL (what a person cannot do, limitations)

Frailty: stage of high vulnerability for adverse health outcomes


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Describe the health care implications for co-morbidity?

Complexity of treating concurrent diseases

Potential for preventing diseases or minimising severity

Fragmentation of services

Minimise risk of disability and frailty


Describe the health care implications for disability?


Social integration and community services

Aim to decrease dependency

Potential for primary, secondary and tertiary prevention 


Describe the health care implications for frailty?

Vulnerable to stressors

Risk of geriatric syndrome

Treat concomitant issues

Progressive but potnetial for primary and secondary prevention 


What is a geriatric syndrome?

How does it differ from a medical syndrome?

Accumulated effect of impairments in multiple domains that together result in a particular adverse outcome 


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What are the 'giants of geriatric medicine'?



Impaired balance

Impaired cognition

Iatrogenic illness