Geriatrics Quiz 2

A physiologic syndrome characterized by decreased homeostatic reserve and resistance to stressors, resulting from cumulative decline across multiple physiologic systems and causing vulnerability to adverse outcomes

frailty definition

homeostatic reserve

the redundancy of physiologic functions used to overcome health issues

What is the frailty threshold within a reserve?

30%

“entryway to frailty”

sarcopenia (aka MSK system)

causes of frailty

chronic inflammation, immune system activation, hormonal deficits, gene expression, genetics, loss of ability to self-correct within the system, disease/injury, lifestyle

what is the GREATEST contributor to frailty

lifestyle

about _____ of community-dwelling older adults are frail

15%

about _____ of older adults in nursing homes are frail

76%

if a patient is 65+ you should offer……

svreen for frailty

frailty model based on # of health deficits that accumulates over time and includes all systems

frailty index

frailty model more relevant to PT

Fried’s frailty phenotype “physical frailty”

5 characteristics of Fried’s Phenotype of Frailty

unintentional weight loss, self-reported exhaustion, low energy expenditure, slowness, weakness

Fried’s Phenotype of Frailty Scoring

3=frail, 1 or 2= pre-frail

gait speed cut off for frailty

< 0.8 m/s

gold standards for grip strength for frailty scores

<30kg men, <20kg women

chair stand cut off for frailty

inability to stand without arms 8x in 30 sec

tool that includes static balance, gait speed, 5x chair rise

Short Physical Performance Battery (SPPB)

Short Physical Performance Battery (SPPB) cut off

8/12 men, 7/12 women (she said 10)

Scale used for frailty for pts with dementia even if physically robust

Clinical Frailty Scale

its better to catch a patient in _____

pre-frailty

most effective way to reduce progression of frailty

vigorous physical activity at least 1x per week

where to start with frailty/prefrail

progressive strength training, especially LE