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Frailty 

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  • Notes on Medicine
  • Chapter 34: Ageing Frailty
  • Frailty 

Frailty 

Frailty 

on 15 Jan, 2025
  • Date15 Jan, 2025

Definition: Frailty is defined as the inability to withstand (সহ্য করা) minor stresses because of reduced functional reserve in several organ systems. Thus, in frailty even a trivial illness may result in organ failure and death.

 

Two approaches to assessment of frailty:

 

Fried Frailty phenotype   Frailty syndromes (Geriatric Giants)
  1. Weak hand grip strength  
  2. Slow walking speed  
  3. Self-reported exhaustion  
  4. Physical inactivity  
  5. Unintentional weight loss
  1. Immobility (decline in function)  
  2. Instability (falls)  
  3. Incontinence  
  4. Intellectual impairment (dementia, delirium)  
  5. Iatrogenic disease and social isolation

 

Clinical Frailty Scale

  1. Very Fit: 
  • robust, active, energetic, motivated; exercise regularly. 

 

  1. Well: 
  • no active disease symptoms but are less fit than category 1. 
  • Often, they exercise or are very active occasionally, e.g. seasonally. 

  • Managing Well: 
  • medical problems are well controlled, 
  • routine walking. 

  • Vulnerable: 
  • Mildly Frail 
  • Moderately Frail
  • Severely Frail 
  • Very Severely Frail 

 

SAQ. Relationship of dementia with frailty

 

Scoring frailty in people with dementia 

  • The degree of frailty corresponds to the degree of dementia.
  • Mild dementia: 
  • forgetting the details of a recent event, though still remembering the event itself, 
  • repeating the same question/story and social withdrawal. 
  • Moderate dementia:
  • recent memory is very impaired, can remember their past life events well
  • can do personal care with prompting. 
  • Severe dementia:
  • cannot do personal care without help.
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