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Understanding and Addressing Frailty in Older Adults: A Comprehensive Approach, Slides of Geriatrics

An in-depth exploration of frailty in older adults, a syndrome characterized by progressive multisystem decline and increased vulnerability to disease and death. Topics covered include the physical, cognitive, psychosocial, and nutritional aspects of frailty, as well as the role of sarcopenia, endocrine changes, and inflammation. The document also discusses the 'vicious cycle' of frailty and various treatment approaches, including exercise, hormonal interventions, anti-inflammatory therapies, and comprehensive geriatric assessment and care.

Typology: Slides

2011/2012

Uploaded on 12/13/2012

sethuraman_h34rt
sethuraman_h34rt 🇮🇳

4.3

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159 documents

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The Clinical Care of the

Frail, Older Adult

Frailty

 Syndrome characterized by

progressive multisystem decline, loss

of physiologic reserve, and increase

vulnerability to disease and death.

◦ Physical ◦ Cognitive ◦ Psychosocial ◦ Nutritional

Tools

Bases

 Sarcopenia: loss of muscle mass and

strength.

◦ Starts at 30, accelerated after 50 ◦ Worsened by chronic illness

 Endocrine: Decreased sex steroid,s DHEA-S,

IGF-1, Vitamin D + increased cortisol 

Sarcopenia, fractures

 Inflammation: Chronic (increased IL-6 , CRP,

WBC (N+macrophages) (significance and

effects)

 Combination

Treatment

 Exercise: regular exercise training.

◦ Improves muscle strength, aerobic capacity, balance, and mobility and reduces falls in older adults. ◦ Improvement of ADLs, quality of life, emotional health, increased chances of independent living, postponement of disability. ◦ Categories:  high-intensity resistance training (muscle mass, strength)  Tai-Chi (reduce falls) ◦ ?Benefit in highly frail ◦ Does NOT increase pain

Treatment

 Hormonal: ?efficacy

◦ Not recommended, unless clearly indicated (deficiency) ◦ Even with replacement, effects are unclear.

 Anti-inflammatory: May yield some effect

(delay frialty)

◦ TNF-α antagonist for Rheumatoid arthritis

Treatment

 Program for All-Inclusive Care of the

Elderly (PACE) (Day-hospital)

◦ LTC services in community (transition) ◦ Involves Geriatric team + HomeCare + Transportation

 Acute Care for Elderly (ACE)

◦ Homelike environment

◦ Patient-centered care, that includes plans for preventing disability and iatrogenic illness

◦ Comprehensive discharge planning and management.