Elderly and frailty

Question 1

Why are people getting older?

Answer 1

> Increased resources

> Better economy

> Improved screening programs and diagnosis with earlier treatment

> Better outcomes following major events:

• Cardiac
• Stroke
• Surgery

Question 2

What is primary ageing?

Answer 2

Primary ageing is the gradual and inevitable process of body deterioration that takes place throughout life.

Primary ageing is genetic.

It is the preprogrammed coding that our bodies follow.

Question 3

What is secondary ageing?

Answer 3

Secondary aging results from disease, lack of physical activity and unhealthy activities (smoking and drinking), poor nutrition and exposure to hazardous materials.

Question 4

What are the advantages of ageing?

Answer 4

Increased experiential learning

Question 5

What are the detrimental aspects of ageing?

Answer 5

Hypertension, decreased reaction time

Question 6

What is the theory of ageing - Stochastic?

Answer 6

> Random

> Cumulative damage

Question 7

What is the theory of ageing - Programmed?

Answer 7

> Predetermined

> Changes in gene expression during various stages of life

Question 8

What theories of ageing are there?

Answer 8

> Stochastic (Random)
Programmed
Homeostatic failure

Question 9

What happens to the inter-individual variability in ageing as we get older?

Answer 9

Increases

Question 10

What happens to the kidneys as we age?

Answer 10

Decreased creatinine clearance , thus increased serum creatinine

Question 11

What happens to the cardiovascular system as we age?

Answer 11

1) Increased systolic BP
2) Decreased diastolic BP after 50-59.
3) Decreased cardiac output

Question 12

What happens to the respiratory system as we age?

Answer 12

1) Vital capacity decreases
2) Residual volume increases
3) Expiratory reserve volume decrease

Question 13

What is frailty?

Answer 13

A susceptibility state that leads to a person being more likely to lose function in the face of a given environmental challenge

It is dyshomeostasis

Question 14

What occurs due to frailty?

Answer 14

> Falls
Delirium
Immobility
Incontinence

Question 15

What happens to the baroreflex sensitivity as we age?

Answer 15

Decreases, increased BP as a result

Question 16

What happens to cold stress as we age?

Answer 16

1) Reduced peripheral vasoconstriction = Increased heat loss

2) Reduced metabolic heat production

Question 17

What happens to heat stress as we age?

Answer 17

1) Reduced sweat gland output
2) Reduced skin blood flow
3) Smaller increase in cardiac output
4) Less redistribution of blood flow from renal and splanchnic circulations

Question 18

How may hyperthyroidism present in frailty?

Answer 18

> Depression
> Cognitive impairment
> Muscle weakness
> Atrial fibrillation
> Heart failure
> Angina

Question 19

With ageing what is the risk surrounding multiple co-existing medical conditions?

Answer 19

1) Different presentations compared to young population
2) Unknown drug efficacy and safety in patients >80 yrs
3) Multiple medications:
- Drug-drug interactions
- Adverse drug reactions