Exam (elaborations)
Geriatric Symptoms & Frailty
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Geriatric Symptoms & Frailty
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GERIATRIC SYMPTOMS & FRAILTYQUESTIONS AND ANSWERS
nWhat is key to understanding age-related disease? - Recognizing and understanding frailty (also
recognizing signs of pre-frailty)
Frailty can adversely influence... - Outcomes
-- Can take an unexpectedly long time to recover from an acute illness
-- Reduced physiologic reserve to overcome illness
*Impact of COVID-19 on the older adult population (esp. when in an institutionalized setting) - reduced
immunity to begin w/ (as an older adult)
Adaptive homeostasis - Extent that the body can adapt to the physiologic stresses and maintain
homeostasis; will influence susceptibility to illness/injury
What contributes to the loss of "energetics," homeostasis, and physiologic reserve? - Multi-system
dysregulation
Organ systems have built-in ________________ structures and function - Redundant (e.g., O2, digestive,
and metabolic systems interact and work together to deliver "fuel" to the correct structures at the
correct time)
Built-in redundancy - Decline/dysfunction in one system can lead to an increased contribution of... -
Another system
% of margin of loss for most systems before evidence of failure presents - 70
Redundancy allows most organ systems to function adequately UNTIL... - A 30% MINIMUM functional
threshold is crossed
The "tipping point" - Loss of reserve capacity is an important dimension of frailty
Physiological systems are easily tipped over the threshold of clinical failure when... - An acute problem
occurs (e.g., chronic renal insufficiency --> a bout of diarrhea causes dehydration and acute renal failure)
Factors associated w/ frailty and cognitive impairment: - -- Lifestyle and mental health factors
, -- Cardiovascular risk factors
-- Nutritional deficiencies
-- Hormonal imbalance
-- Social factors
-- Inflammation
-- Poor health and medication use
(Overlap present)
Prevalence of frailty - (Looking at >7000 community-dwelling Medicare enrollees over the age of 65)
--15.3% = frail (w/ 3 out of the 5 attributes based on the physical frailty phenotype)
--45.5% = pre-frail (having 1-2 out of the 5 attributes)
Prevalence of frailty in nursing homes = - ~76 (w/ remainder of individuals considered to be pre-frail)
Key risk factors for frailty: - -- Increased age
-- Female
-- Black/Hispanic
-- Lower level of education
-- Lower socioeconomic status
-- Poor self-rated health
-- Presence of co-morbidities
-- Presence of disease
Increased age as a key risk factor for frailty - -- Only 9% in the 65-69 age bracket
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