You are on page 1of 5

SP- Geriatrics-> Frailty

1. ______ If the central focus of geriatric medicine


2. The definition of this temr is old-old age is ____ or older, with ___
-_____ dz, and a ______/_______.
3. The 2004 American Geriatrics Society. National Institute of Aging
on frailty in older adults describes frailty as a state of increased
__________ to _______ due to age related declines in physiological
reserve across ______ , ______ and _____ systems.
4. _________ is a declined physiological reserve hence decreased
ability to keep yourself in homeostasis.
5. Frailty is a _____ syndrome of decreased ______ in multiple
systems that results from _______ that can occur with aging
6. In aging we can see loss of ______ muscle, aka _______.
7. there is also change in n___-_____ systems, _ _ -1, and C_______.
8. Note a decreased s_____ with aging -> due to s_____ (loss of ____
mass) , i______, disease, under-________, and i_______.
9. Neuro-endocrine changes show a decreased _____ hormone and _
_ _-1, decrease _ _ _ -S, decreased t______, e______.
10.
Increased c_______ and increased _____ nervous sytem via
which NT?
11.
Inflammation shows elevated levels of IL-__ and _ _ _.
12.
This interleukin above will inhibit production of _______ or
interfere with _____ metabolism . It also is associated with loss of
m_____ m______ and o_________.
13.
A survey done by Williamson and Fried stated that 97%
Geriatrician indicated that clinically apparent fraily involves
one or more of the following: ____ loss, or s_____, w______.
Low ___ tolerance, slowed _____ performance, and low ____
levels.
14.
The physiology of frailty shows increased IL-_, increased
factor _ and increased _________ (as stated before)
15.
After this the clinical _____ of frailty shows _____ loss and &
______ performance.
16.
The outcome of this frailty is increasd chance of f_____,
d_______, d______, and eventual d______.
17.
Chronic under______ can result from inadequate
intake of ptrotein-> this leads to loss of ____ mass->>
lower _ _ _ max, decreased strength, and ______ resting
metabolic rate. Overall there is a ______ total energy
expenditure results.
18.
Cardiovascular Health Study predicted a group at high risk
of adverse outcomes that geriticirna associated with being ____.
19.
CHS found _______-dwelling adults ___ years or older with 3
ore more fo the five criteria: ___ loss (__% in last year)
- e______ (+ question in regarding effort required for activity)

_____ activity (Kcal spent per week: males exepnidng < ___Kcal , and females < _____- Kcal.
W_____ time being > __to __ seconds to move ___feet.
G____ s_____

20.
overall it was found that 3% were ___-____ while 26% was
between ___-___.
-3 year incidence of frailty was 7%
21. The study results showed that those who were frail were at
high risk of m______, f_____. H_____ and incident or worsineing of _____.
22. there was a__.___ fold increasd risk of each of these
outcomes listed in the last question
23. This study showed this these criteris could be used as a _____
to identify phenotypic fraity in individuals.
24. Other proposed features of frailty include impairments in
c_____. B_____. _____ processing and changes in _____ status such as
d_____.
25. there is also low self rated ____ and less ____ support.
26. T/F Frailty is only found in older people and in those with
multiple conditons.
27. T/F Fraility can be used synonymous with disability and
comorbidity.
28. _____ is difficulty or dependence in carrying out activities that
are essential to _____ living.
29. 40% of physicians felt ______ causes disability and may
predict it.
30. Comorbidity is concurrent presence of ___ or more medically
dx dz in the same person. CHS found 7% of people classified did not
have comorbidity , 25% had one. It was hypothesize that frailty is a
_____ syndrome that can occur as the ___ stage of a number of ____ dz.
31. Dz states that can affect frailty include : _ _ _, occult ________.
Chronic _______, r_____ a______, p______ r_______, major ______, P______
dz.
32. The new diagnostic approach is ____ and ____ rather than
targeting just comrobiidty or disability. Chin et al. found _____ loss and
i______ as important criteria of fraility.
33. Leng et al. concluded that higher __ __ __, and IL-___ were
indepdenatly associated with prevalent frailty among what population?
34. Key factor in treatment of frailty is an ___-____ approach. The
goal is to optimize ____ at the highest level and avoid _____ visitis.
35. Successful interventions focus their efforts on ____-risk pts
with ______ problems or who would benefit from s________.
36. Assessment during treatment requires having appropriate
e_____ available identify medical and nonmedical needs to have
effective intervention.

37. Knowing and using the up-to-date evidence based ______ that
make a difference is key to improving ________.
38. integrating ________ improvmetns into the design of care
facilties impletation of real improvments over time

1. Frailty
2. 85 or older with co-morbid dz, dependence/disability
3. vulnterablity to stressors, across nueromusuclar, metabolic, and
immune systems
4. homeostenosis
5. biological ynsdrome -> decreasesd rserve
6. skeletal muscle-> sarcopenai
7. neuroendrogcirne systems, IGF-1, and cortisol
8. strength-. Sarcopenia(loss of muscle mass), infection, disease,
under nutrition, and inflammation
9. growth hormone, IGF-1, dhea, DEREAST TESROENE,
DESTREOCED ESTROGEN
10.
cortisol and sympathetic nervous system-> NE
11.
inflammation -> IL-6 and CRP(THE KEY TO ALL PATHOLOGY)
12.
Erythropoietin, or interfere with iron metabolism. Los of
muscle mass and osteoporosis All related to elevated levels of
IL-6

13.
Weight loss , sarcopenia, weakness, low exercise tolerance,
slowed task performance and low activity levels
14.
IL-6, factor 8, and increased cortisol
15.
Clinical syndrome of frailty, and weight loss and slowed
performance
16.
Falls, disability, dependence, and death
17.
Undernutriton-> inadequate intake of protein. This leads to
loss of muscle mass , lower VO2Max, decreased sstrength ,
decreased resting metabolic, decreased total energy expenditure
18.
Frail
19.
CHS found community-dwelling adults 65 years or older
with 3 ore more fo the five criteria: weight loss (5% in last year)
- exhuastion (+ question in regarding effort required for
activity)
- physical activity (Kcal spent per week: males exepnidng <
383Kcal , and females < 270Kcal.
- Walk time being > __to __ seconds to move ___feet.
- Grip strength
20.
65-70. 85-89 more likely to be frail
21.
mortaility, falls, hospitlizaiton, incident or worsening of
disability
22.
2.2 fold
23.
screening
24.
impariemtns in cognition, balance, motor processing, and
emotion status like depression
25.
there is a low self rated health and less social support
26.
False-> can exist indepndnt of age, diablity, or dz.
27.
False-> should be distinguished between other terms
28.
Disability-> hard time carrying out activiites essential to
independent living.
29.
Frailty
30.
Two, wasting syndrome, end stage of a number of chronic
dz
31.
CHF occult malignancy Chronic infection, rhueamtoid
arthitirs, polymyalgia rhuematica, major depression , Parkinsons
dz.
32.
Signs and symptoms are key, weight loss and inactivity
33.
WBC, IL-6-- community dwelling older women
34.
Interdisciplinary/multidisciplinary approach -> increase
function and avoid hospital visits
35.
High risk pts with reversible problems or who would benefit
from stabilziaionts
36.
Approiate expertise
37.
Treatment, outcome
38.
Performance imporvements