What is Frail? What is Frail? recent weight loss recent weight - PowerPoint PPT Presentation

What is Frail? What is Frail? � recent weight loss recent weight loss � � self self- - reported exhaustion reported exhaustion � � poor grip strength poor grip strength � � slow walking speed slow walking speed � � low physical activity low physical activity � Fried, Linda

Systolic vs. Diastolic Heart Failure Systolic vs. Diastolic Heart Failure � Type of ventricular dysfunction found Type of ventricular dysfunction found � different between elderly and different between elderly and younger younger � Approximately 40% to 50% of Approximately 40% to 50% of � elderly patients with heart failure elderly patients with heart failure have normal left ventricular systolic have normal left ventricular systolic function with predominantly diastolic function with predominantly diastolic dysfunction dysfunction

Cardiac Ischaemia Ischaemia and MI and MI Cardiac � Angina and equivalents Angina and equivalents � • Exertional Exertional angina angina - - most common most common • manifestation of myocardial ischemia in manifestation of myocardial ischemia in young and middle- - aged aged young and middle • In elderly, In elderly, dyspnea dyspnea also common also common • • Asymptomatic, although silent ischemia Asymptomatic, although silent ischemia • also frequent - - demonstrable by stress demonstrable by stress also frequent testing or Holter Holter monitoring. monitoring. testing or

Cardiac Ischaemia Ischaemia and MI and MI Cardiac � Acute MI Acute MI � • 4 5 % of 4 5 % of MI s MI s w ere silent or unrecognized w ere silent or unrecognized • • percentage increased w ith the patient's percentage increased w ith the patient's • age in m ales ( Fram ingham ) age in m ales ( Fram ingham ) • I nstead of chest pain, elderly patients • I nstead of chest pain, elderly patients m ore com m only com plain of dyspnea dyspnea or or m ore com m only com plain of have vague sym ptom s of confusion, have vague sym ptom s of confusion, abdom inal pain, or generalized w eakness abdom inal pain, or generalized w eakness at the tim e of acute MI . at the tim e of acute MI . • Main cause of death in elderly patients Main cause of death in elderly patients •

Factors that contribute to the atypical Factors that contribute to the atypical presentation of infection in the elderly presentation of infection in the elderly � Underreporting of illness Underreporting of illness � � Compromised cognition Compromised cognition � � Coexisting diseases Coexisting diseases mask mask � � Altered physiologic responses Altered physiologic responses �