Frailty & Geriatric Pharmacology Flashcards
(29 cards)
How is frailty conceptualized by healthcare providers?
- a state of late life decline and vulnerability
- characterized by weakness and decreased physiologic reserve
The increased vulnerability of the elderly contributes to increased risk for…..
- falls
- institutionalization
- disability
- death
_______ itself does not define frailty.
Old age
Frailty exists on a ______.
The end stage of the continuum of frailty is _______.
spectrum
failure to thrive
Most definitions of frailty describe a syndrome that is marked by…….
- loss of function, strength, physiologic reserve
- increased vulnerability to morbidity and mortality.
What are the 3 most commonly used measurements for frailty screenings?
- physical function
- gait speed
- cognition
The presence of __________ increases the likelihood of adverse health outcomes in geriatric patients.
cognitive impairment
What are the 3 most commonly used definitions of frailty?
- Cardiovascular Health Study (CHS)
- Fried Frailty Phenotype
- Study of Osteoporotic Fractures (SOF)
- Rockwood Frailty Index
How does the Cardiovascular Health Study Index define frailty?
3 or more of the 5 criteria
- Weight loss
- Exhaustion
- Weakness
- Slow walking speed
- Decreased physical activity
How does the Study of Osteoporotic Fractures index define frailty?
at least 2 of 3 components
- Weight loss of 5% in last year
- Inability to rise from a chair w/o use of arms
- A “no” response to the question “Do you feel full of energy?”
How does the Rockwood frailty index define frailty?
- Uses 70 variables that range from medical conditions to functional decline
- The higher the score in this index, the more frail the individual
- Especially well suited for mortality risk assessment
Frailty studies are often used to estimate _______.
adverse outcomes
Frailty prevalence increases with _____.
The prevalence of frailty is more prominent in (women/men).
age
women
Women who became frail were…….
- older
- less educated
- more likely to be current smokers
- more likely to be current hormone therapy users
In which population is frailty more common?
- African Americans
- Asians
- Caucasians
- Hispanics
African Americans & Asians
What is the relationship btwn intellectual disability & frailty? Depression?
They are both associated with an increased risk of frailty
Dysregulation in the ________ system is a key feature of frailty.
The basis of this dysregulation is likely related to….
stress response
age-related molecular changes, genetics, specific disease states
What are the 2 most common stress responses in frailty?
What does this contribute to?
- Inflammatory & endocrine pathways
- Contribute to decline in skeletal muscle
What is Sarcopenia?
What parts of the endocrine & inflammatory pathways contribute to sarcopenia?
- Age-related loss of skeletal muscle & muscle strength
- Lower levels of IGF-1 & DHEA-S
- Inflammatory cytokines
What are the multiple hormone changes that occur with frailty?
- Decline in sex steroids
- Low SHBG, low testosterone
- Increased GH
- Low IGF-1
- Low DHEA-S
- Cortisol levels higher in late afternoon
- Low 25(OH)D
Inflammation & Immunity
Serum levels of what substances are elevated in frail adults?
- Pro-inflammatory cytokine IL-6
- C-reactive protein
- WBC count
- Monocyte count
Chronic elevation of IL-6 contributes to ______.
There is an association btwn frailty & __________.
anemia
clotting markers
Stress & metabolic systems
Age related changes in _________ & ________ likely impact sarcopenia & inflammation.
Dysregulated _____, ______, ______, & _____ response systems are important to the development of frailty.
renin-angiotensin system, mitochondria
immune, endocrine, stress, energy
_________is believed to be the most effective of all interventions proposed to improve quality of life and functionality in older adults.
Exercise
exercise + weight loss diet better than either alone
