Geriatrics

Question 1

What does a comprehensive geriatric assessment involve?

Answer 1

• Medical diagnosis
• Review of medicines and concordance with drug therapy
• Social circumstances
• Assessment of cognitive function and mood
• Functional ability
• Environment
• Economic circumstances

Question 2

What are the geriatric giants?

Answer 2

• Incontinence
• Immobility
• Instability (falls and syncope)
• Intellectual impairment (delirium and dementia)

Question 3

What are key aspects that older people consider important?

Answer 3

• Being valued as a person e.g. listened to
• Being given privacy during care
• Having assistance with and enough time to eat meals
• Being asked how one prefers to be addressed
• Having services that are designed with older people in mind

Question 4

What is Fried’s Frailty Phenotype?

Answer 4

• Walking speed
• Grip strength
• Weight loss
• Fatigue
• Activity level

Question 5

What is the frailty index?

Answer 5

• Measured by comparing ratio of health deficits present to possible health deficits
• Allows inclusion of any health deficits providing that a minimum of 30 deficits are included and each deficit is associated with adverse health outcomes, increases in prevalence with age and has a prevalence of at least 1% in the population
• A total score of 0.7 (70% of the deficits) means the person is close to death

Question 6

What is the clinical frailty scale?

Answer 6

The frailty index can be simplified into a frailty scale. The health professional considers info about cognition, mobility, function and co-morbidities based on the hx and exam to assign a frailty level from 1 (very fit) to 9 (terminally ill with a life expectancy <6 months).