Frailty Syndrome, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

This book describes the Frailty Syndrome, Diagnosis and Treatment and Related Diseases
While it lacks a standardized medical definition, older adults’ frailty requires special considerations in terms of treatment and nutritional needs.

Frailty Syndrome is a distinct medical syndrome where the aged individual has low reserves and is highly vulnerable to internal and external stressors.
While it is linked with disability and multiple co-morbidities, it can also be present in individuals who seem healthy.
Based on this conceptual framework, two major definitions with proposed assessment tools have emerged over the past decade also:
1. The frailty phenotype (FP),
2. The frailty index (FI).

A number of other definitions have also been described such as:
1.FRAIL (Fatigue, Resistance, Ambulation, Illnesses, Loss of weight)
2.Frailty Instrument for the Survey of Health, Ageing and Retirement in Europe (SHARE-FI), and
3.The Groningen Frailty Indicator.
While no single operational definition or simple assessment tool has been agreed upon, a consensus has been agreed that Frailty:
1.Is a medical syndrome,
2.Indicates higher vulnerability to stressors, leading to functional impairment and adverse health outcomes,
3.Might be reversible or attenuated by interventions, and
4.Is treatable in primary care.
Frailty phenotype
The phenotypic definition of frailty as a geriatric syndrome was suggested and tested in the CHS, older men and women in the USA.
Frailty is operationally described as a syndrome meeting three or more of five phenotypic criteria:
1.Low grip strength: lowest 20% (by sex, body mass index),
2.Slowness by slowed walking speed - Walking time/15 feet: slowest 20% (by sex, height),
3.Low level of physical activity - Kcal/week: lowest 20%
(Males: 383 Kcal/week; Females: 270 Kcal/week)
4.Low energy or self-reported exhaustion, and poor endurance
5.Unintentional weight loss >10 lb lost unintentionally in a previous year
A pre-frail stage, in which one or two criteria are present, recognizes a subset at high risk of progressing to frailty.
Older persons with none of the above five criteria are classified as non-frail.
This definition diagnoses frailty as a distinct medical entity differentiated from disability
While many (but not all) frail persons are disabled, not all disabled persons are frail.
Frailty index
The frailty index defines frailty as the collective deficits identified in a complete geriatric appraisal.
The criteria for a variable to be regarded as a deficit are :
1.Acquired,
2.Age-linked,
3.Linked with an adverse outcome, and
4.Should not saturate too early.
Recent advances in the pathogenesis of frailty described in the section are almost exclusively based on the Frailty Phenotype definition.
Causes:
These disorders are each individually linked with a higher chance of frailty:
1.A pro-inflammatory state
2.Sarcopenia
3.Anemia
4.Relative deficiencies in anabolic hormones (androgens and growth hormone)
5.Excess exposure to catabolic hormones (cortisol),
6.Insulin resistance
7.Glucose levels
8.Compromised altered immune function
9.Micronutrient deficiencies and
10.Oxidative stress
Symptoms:
1.Anorexia or poor appetite
2.Sarcopenia or loss of body mass
3.Immobility or decreased physical activity
4.Atherosclerosis
5.Balance impairment
6.Depression
7.Cognitive impairment
Diagnosis:
A range of tests for identifying frailty are available
1.PRISMA 7 Questionnaire
2.Groningen Frailty Indicator questionnaire
3.Slow walking speed
Treating Frailty:
1.Complete exercise
2.Complete medicine review
3.Nutrition
Increase food intake
Enough proteins
Orexigenic agents for appetite
4. Hormone -male/female
5.Balance exercise
6.Mobility
TABLE OF CONTENT

• Language: English
• Publisher: Kenneth Kee
• Release date: Jun 6, 2018
• ISBN: 9780463282694

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Frailty Syndrome,

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2018 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes the Frailty Syndrome, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What The patient Need to Treat Frailty Syndrome)

This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Frailty Syndrome

While it lacks a standardized medical definition, older adults’ frailty requires special considerations in terms of treatment and nutritional needs.

What is Frailty Syndrome?

Frailty Syndrome is a distinct medical syndrome where the aged individual has low reserves and is highly vulnerable to internal and external stressors.

While it is linked with disability and multiple co-morbidities, it can also be present in individuals who seem healthy.

Frailty is thought as a medically recognizable state of raised vulnerability resulting from age-linked decrease in reserve and function across multiple physiological systems such that the ability to cope with everyday or acute stressors is compromised.

Based on this conceptual framework, two major definitions with proposed assessment tools have emerged over the past decade also:

1. The frailty phenotype (FP), also known Cardiovascular Health Study (CHS) definition, and

2. The frailty index (FI).

A number of other definitions have also been described such as:

1. FRAIL (Fatigue, Resistance, Ambulation, Illnesses, Loss of weight)

2. Frailty Instrument for the Survey of Health, Ageing and Retirement in Europe (SHARE-FI), and

3. The Groningen Frailty Indicator.

Most international efforts have recently been made to reach frailty consensus.

While no single operational definition or simple assessment tool has been agreed upon, a consensus has been agreed that Frailty:

1. Is a medical syndrome,

2. Indicates higher vulnerability to stressors, leading to functional impairment and adverse health outcomes,

3. Might be reversible or attenuated by interventions, and

4. Is treatable in primary care.

Frailty phenotype

The phenotypic definition of frailty as a geriatric syndrome was suggested and tested in the CHS, a large-cohort study of community-dwelling older men and women in the USA.

Frailty is operationally described as a syndrome meeting three or more of five phenotypic criteria:

1. Low grip strength: lowest 20% (by sex, body mass index),

2. Slowness by slowed walking speed - Walking