NURS 306: Week 6 - Missed, Missing, and Mis-Diagnosis: Care Gets Complicated

What are geriatric syndromes?

Common health conditions in older adults that do not fit into a single disease category.

Why do geriatric syndromes matter?

- Highly prevalent in older adults

- Predicts outcomes better than disease alone

- Associated with increased risks

What are some false facts about geriatric syndromes?

- They are a normal part of aging

- They are explained by a single disease

- They are best managed by disease-specific guidelines

What are the most common geriatric syndromes?

- Falls

- Polypharmacy

- Delirium

- Dementia

- Depression

- Urinary incontinence

- Malnutrition

- Functional decline

- Sarcopenia

- Pressure injuries

Falls are the most common geriatric syndrome leading to injury and hospitalization (True/False).

True

1 multiple choice option

What are some multifactorial causes of falls?

- Balance

- Strength

- Vision

- Medications

- Environment

What can polypharmacy lead to?

- Falls

- Delirium

- Functional decline

- Adverse drug reactions

What are some risk factors for polyphamaracy?

- Multiple comorbidities

- Frequent healthcare transitions

- Cognitive impairment

What is delirium?

Actue, fluctuating disturbance in attention and cognition.

What are some triggers for delirium?

- Acute illness

- Medications

- Surgery

- Stressors

What are some risk factors for delirium?

- Hospitalization

- ICU

- Post-surgery

What is dementia?

A progressive decline in memory, thinking, and functional abilities.

Dementia is a type of Alzheimer's (True/False).

False

1 multiple choice option

What are some subtle or atypical s/s of depression in older adults?

- Fatigue

- Withdrawal

- Sleep disturbance

- Cognitive changes

Depression often coexists with chronic illness, functional decline, and other geriatric syndromes in older adults (True/False).

True

1 multiple choice option

What is depression associated with?

- Reduced quality of life

- Increased morbidity

- Higher healthcare utilization

What are some causes of urinary incontinence in odler adults?

- Mobility limitations

- Cognitive impairment

- Medications

- Medical conditions

What is urinary incontinence associated with?

- Falls

- Skin breakdown

- Social isolation

- Reduced quality of life

What are some causes of malnutrition in older adults?

- Chronic illness

- Medications

- Oral/dental issues

- Depression

- Social factors

What is malnutrition associated with?

- Frailty

- Impaired immune function

- Falls

- Delayed recovery

What is functional decline?

The loss of the ability to perform ADLs and IADLs.

What are some causes of functional decline?

- Illness

- Frailty

- Cognitive decline

- Geriatric syndromes

What is sarcopenia?

Age-related progressive loss of skeletal muscle mass, strength, and function.

What are some risk factors for sarcopenia?

- Aging

- Inactivity

- Malnutrition

- Chronic disease inflammation

What is sarcopenia associated wth?

- Increased risk of falls

- Functional decline

- Frailty

- Hospitalization

- Mortality

What are some risk factors for pressure injuries?

- Immobility

- Incontinence

- Malnutrition

- Comorbidities

- Frailty

- Sensory impairment

What are pressure injuries associated with?

- Pain

- Infection

- Delayed healing

- Prolonged hospitalization

- Increased mortality

What is frailty?

A clinical state of increased vulnerability due to reduced physiological reserve across multiple systems.

What are some common clinical criteria for frailty?

- Unintentional weight loss

- Weakness

- Slow walking speed

- Exhaustion

- Low activity

Frailty is multidimensional and can involve physical, psychological, and social vulnerability (True/False).

True

1 multiple choice option

What factors does the Balducci frailty model consider?

- Age

- ADL/IADL

- Dependence

- Comorbidities

- Geriatric syndromes

Frailty is a dynamic and potentially modifiable condition (True/False).

True

1 multiple choice option

What is social frailty?

Involved reduced social resources, engagement, and participation.

What are key domains of social frailty?

- Living arrangements

- Social network and support

- Social participation and roles

- Economic resources

Social decline can be a precursor to physical or cognitive decline (True/False).

True

1 multiple choice option

What are some tools used to measure social frailty?

- Tilburg Frailty Indicator

- Social Frailty Index

- Kihon Checklist

Why is recognizing frailty important?

- Predicts adverse outcomes

- Guides care planning

- Improves patient outcomes

- Supports risk stratification

- Promotes research and policy

What are some common frailty assessment tools?

- Fried Frailty Phenotype

- Clinical Frailty Scale

- Frailty Index

- Geriatric 8 Screening Tool

- Edmonton Frailty Scale

What is the Fried Frailty Phenotype (FFP)?

- Assess weight loss, exhaustion, physical activity, grip strength, and walking speed

- Grades frailty based on robust (0), prefrail (102), and frail (3-5)

What is the Clinical Frailty Scale (CFS)?

- Assess overall fitness/frailty based on clinical judgement

- Ranged from very fit (1) to terminally ill (9)

What is the Frailty Index (FI)?

- Assess accumulation of deficits across multiple domains

- Scored based on ratio of deficits present to total deficits considered

What is the Geriatric 8 Screening Tool?

- Used in oncology setting to detect frailty risk in older adults

- Scores from 0-17, with a lower score indicating a higher risk

What is the Edmonton Frail Scale (EFS)?

- Assesses frailty risk using multiple domains

- Scores from 0-17, with a higher score indicating a higher risk

Frailty is mainly diagnosed by elevated inflammatory markers (True/False).

False

1 multiple choice option

What are some common domains of biological markers used to diagnose frailty?

- Chronic inflammation

- Endocrine dysregulation

- Oxidative stress

- Nutritional deficiencies

Frailty is a major factor in explaining why older adults develop multiple geriatric syndrome (True/False).

True

1 multiple choice option

Geriatric syndromes rarely occur together and overlap with each other (True/False).

False

1 multiple choice option