Flashcards in Ageing and Frailty Deck (19):
What is the main factor driving the compression of mortality?
Social engineering (e.g. better housing and sanitation, clean water, nutrition) not medical interventions (although some have contributed, e.g. immunisations, improved maternal health)
What is going to be one of the challenges to developing countries in light of their rapid increase in the average lifespan?
Increased burden on social programs
What is the importance of compression of morbidity?
When lengthening the average lifespan, we want also to compress morbidity to avoid extending number of years lived with disease and disability
Define cellular senescence. How does it differ from apoptosis?
The phenomenon where cells lose the ability to divide; both senescence and apoptosis can occur in response to DNA damage, but apoptosis occurs where the damage is irreversible
What is organismal senescence?
The ageing of whole organisms
What is frailty?
A distinct clinical syndrome associated with a low-grade chronic activation of the immune system and abnormalities of the endocrine and coagulation systems, conferring high risk for adverse health outcomes
Which biomarkers are used to assess frailty?
2-4x increase in cytokines compared to those in infective or inflammatory states, particularly:
What is the difference between high levels of CRP, IL-6 and TNF-a in terms of their prognosis?
No clear link between CRP and mortality
High IL-6 associated with mortality, and decreased muscle mass and strength
TNF-a associated with mortality
What is sarcopenia?
The ageing of skeletal muscle
List 5 factors contributing to sarcopenia
Altered CNS and PNS innervation (loss of anterior horn cells and ventral root fibres)
Altered hormonal status (decreased GH, IGF-1, oestrogen and testosterone)
Inflammatory effects (increased IL-1 and IL-6 receptor antagonist)
Altered caloric and protein intake
When does decline in muscle mass begin? When does it become substantial?
Decline begins in 40s
Becomes substantial in 60s
Which muscle fibres are preferentially lost? What kind of movements are these fibres responsible for?
Type 2 (fast twitch)
Responsible for fine, precise, rapid movement
Which cytokines are postulated to cause anorexia?
IL-6 and TNF-a
What are Fried's 5 criteria for frailty?
Unintentional weight loss
Slow walking speed
Low physical activity
How many of Fried's criteria must be fulfilled to be assessed as pre-frail? Frail?
1-2 for pre-frail
≥3 for frail
What does ADL stand for?
Activities of daily living
Physical or mental impairment limiting at least 1 major ADL
Distinguish between a medical syndrome and a geriatric syndrome
A medical syndrome involves multiple phenomenologies contributing to a single specific morbid process
A geriatric syndrome involves a specific phenomenology resulting in multiple morbid processes