Medical Complexity Part 2: Defining Frailty and Age-Related Changes
Presented by Jennifer Bottomley
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This course is part of our GCS Prep-Program. Learn more about the full prep-program here: MedBridge GCS Prep-Program.
This seminar focuses on changes specific to the aging process that lead to frailty in the elderly. A systems approach strategy is presented for assessing anatomic, physiologic and functional changes associated with aging and pathologies that result in frailty, changes in postural control, balance and falls in the elderly. This course examines medical complexity and the implications leading to frailty in the elderly providing the course participants with the most advanced and up to date information on the evaluation and treatment of the elderly individual with multisystem involvement. This is Part Two of a series that will present the basic definitions and pathological conditions that lead to frailty, such as congested heart failure, osteoporosis, renal failure, diabetes, Alzheimer’s disease and the like.
Meet your instructor
Jennifer Bottomley
Jennifer M. Bottomley, PT, MS, PhD, embodies the characteristics of leadership, having worked on committees and task forces and behind the scenes to advance the goals and vision of the profession of physical therapy for 40 years. Bottomley is an independent geriatric rehabilitation program consultant, advisor, and educator.…
Chapters & learning objectives
1. Neurosensory System
The neurosensory system in the older adult goes through predictable changes, which have functional implications for the older adult. Clinicians in all settings need to appreciate these changes, both in the central and peripheral nervous system, and how the syndrome of frailty can occur in the presence of decreased activity level and nutritional compromise.
2. Cardiopulmonary & Cardiovascular Systems
The cardiopulmonary system in the older adult goes anatomic and physiologic. There are changes that are important for the treating clinician to understand when assessing and treating this population, like when to look at the detrimental effects of inactivity and the potential presence of frailty. Understanding how to evaluate and test the cardiopulmonary system is essential for interpreting baseline status, as well as response to activity, whether during functional activities or with exercise. This understanding can give perspective on whether the patient you are treating is deconditioned, or whether there are red flags that require further testing by a physician.
3. Neuroendocrine System
The neuroendocrine system plays an important role in the maintenance of homeostasis across multiple systems, and its decline in function related to aging and the disease process directly impacts the syndrome of frailty. Likewise, immune system compromise and the resulting inability to fight infection due to the aging process and presence of disease can lead to frailty. Consequently, understanding the physiologic and pathophysiologic processes of neuroendocrine and immune system function is of great importance for the treating clinician.
4. Cognitive Changes
Cognitive changes in the older adult have particular relevance to the treating clinician, and understanding the potential etiology of these changes, whether from sleep changes, memory changes, or intellectual impairment, is important for providing comprehensive care to this population. Understanding the important questions to ask the older adult about sleep, as well as the tools to screen for memory and cognitive impairment, allows the clinician to know when to refer for a more comprehensive work up.
5. Metabolic Changes
This chapter will take a look at the way metabolism changes with the increase in age. Specifically we'll look at fall risk and becoming more comfortable to screen yourself and patients. This will include an in-depth questioning with a patient so we can get an idea of the types of questions we need to ask.
