Frailty Flashcards
(10 cards)
What are theories of ageing?
Stochastic
- cumulative damage
- random
Programmed
- predetermined
- changes in gene expression during various stages
Homeostatic failure
Describe dyshomeostasis
Point of physiology is to maintain a steady state
Impaired function of any organ system makes this more difficult
Frailty is essentially progressive dyshomeostasis
Describe frailty
Essentially progressive dyshomeostasis
A susceptibility state that leads to a person being more likely to lose function in face of given environmental challenge
This results in “frailty syndromes’
What are “frailty syndromes”?
Falls
Delirium
Immobility
Incontinence
What is social dyshomeostasis?
Difficulty caused by environmental insults not only bio-medical
Ageing often associated with whole system dyshomeostasis
- different ability to compensate
How can drugs cause falls?
Decrease; BP, HR, awareness
Increase; urine output, sedation, hallucinations, qTC, dizziness
What are ‘culprit drugs’ in falls in elderly patients?
Antihypertensives
BBlocker
Sedative
Anticholinergics
Opioids
Alcohol
Important considerations in the systematic enquiry history of a fall
Memory; ideally also ask a relative
Urinary symptoms
Has walking changed recently?
Drugs; everything esp OTC and alcohol consumption
Important features of examination in a fall patient
Get patient on couch
Head and arms; cranial nerves, check glasses, check neglect, cerebellar signs, bradykinesia, rigidity
Pulse, heart sounds, signs of heart failure and resp disease
Kyphosis
Abdo examination
Legs; feet, sensation, vibration, proprioception
Romberg’s and gait
When to CT a head injury?
Immdeiately if
- low GCS < 13
- still confused after 2hrs or not returned to baseline cognitive state
- focal neurology
- signs of skull fracture
- basal skull fracture; CSF leak, bruising around eyes
- seizure
- vomiting
- anti-coagulation
