Frailty: A Condition of the Elderly

Individual factors were found to be a predictor of functional limitation and frailty in older adults. Several studies showed that personal characteristics, such as ethnicity, female gender and age (Espinoza & Hazuda, 2015), gene (Interleukin-18 gene) (Mekli, Marshall, Nazroo, Vanhoutte, & Pendleton, 2015), education and health status, demonstrated an association with frailty (Chang et al., 2015; Chen et al., 2014; Fried et al., 2001; Mitnitski et al., 2015; Tocchi, 2015). Furthermore, it is clear that comorbidities such as diabetes mellitus (DM), stroke, hip fracture, history of coronary heart disease (CHD) and arthritis significantly increase the risk of frailty (Ambrose, Cruz, & Paul, 2015; Zaslavsky et al., 2013).

In the later stages, the individual may become emotionally and physically frail and their reliance on care will increase to the point where they will no longer be able to care for themselves.

This article addresses an important issue on how to develop frailty assessment tools in older adults with musculoskeletal disorders. Why is this topic more essential? Frailty has found in various fields of chronic diseases not only in musculoskeletal disorders. I am interested in frailty; however, it is tricky to determine who present frail in older adults having physical function limitation. Therefore, the different among physical function limitation, immobility, and frailty are still hard to justification. For example, older adults having secondary or third osteoarthritis always presents with severe pain at the knee joint. This pain also interferes his/her physical function. The more joints movement, the greater pain emerge. Reducing severe

As people get old a few of them will experience changes in cognition with age related capacity rather than intellectual capacity. There are some people who get both disparities of mentally and physically impaired that will led into depression due to aging process of their body. Even though, the forgetfulness is a common among older adults, we as healthcare providers must evaluate altered mental status of the patients. “The evaluation and management of altered mental status are broad and require careful history and physical examination to eliminate life-threatening situations”(Patti & Dulebohn, 2017). Therefore, it is very important to recognize the importance of difference between normal age-related symptoms and developing new health problems that can arise in this specific population. As elders get older their memory lapses it frustrating to them leading them to be more worried about changes in their memory. Nurses have a unique capability to promote a cognitive health and determine the possibilities of potential cases of the impairment in elders. The movie “On Golden Pond” Mr. Norman was a perfect example and showed that his symptoms were interfering with his everyday live when he almost burns down the house with fire, calling Bill by his daughter’s name Chelsea and getting lost in on the lake. Even though, Mr. Norman had heart and dementia problems his wife never discouraged him to do what he liked such as

The clinical features Mrs Lee now 83 is displaying changes to health and cognition noted in the last three to four months, with two transient ischaemic attacks but no significant medical issues. Although currently taking three medications for high blood pressure. Changes in word finding, getting words mixed up and confusing identifying words. Insisting everything is fine showing a lack of insight into her changes or difficulties. Short term memory Mrs Lees has difficulty retaining recent memories, however long term memory appears reasonable. Although Mrs Lees home is reasonably well maintained, she is emaciated and personal hygiene is poor. There is also evidence of emotionally Liable being frequently teary with no reason. History includes

There are physiological changes that occur within all systems of the elderly. These changes provide challenges to providing quality care. The following is an example from each of the systems. The integumentary system has a decrease in subcutaneous fat, this increases the potential for decubitus ulcers. The musculoskeletal system has a decrease in bone density, which can contribute to falls. Diminished deep sleep develops due to changes in the neurologic system. This may result in weight fluctuations resulting from changes in appetite. The cardiovascular system causes a decrease in arterial compliance, resulting in increased risk of tachyarrhythmias. The Immune system has a decrease in immune response, resulting in the potential for delayed or incomplete healing. The respiratory system suffers from decreased

Geneva is in the later adulthood life-span stage developmentally, According to Zastrow & Kirst-Ashman, she is physically where she should be as far as her health. She is experiencing normal developmental occurrences for older adults. However, due to normal aging, she has developed arthritis, hearing loss, forgetfulness, diabetes, and depression. She is a breast cancer survivor. She is experiencing senescence, the proper process of physical change that accompanies aging. Enduring all these changes in her life, she maintains resiliency.

Age progression can be a trying time, especially when additional elderly care is necessary due to the physical and mental changes happening. Loss of strength, loss of function, and loss of memory are some common occurrences that the "sandwich generation" notices in their elderly

Frailty is a common clinical syndrome in older persons that carries an increased risk of poor health outcomes. Frailty has been described as “a physiologic state of increased vulnerability to stressors that decrease physiologic reservoirs, resulting from aging and decrease function of multiple physiologic organs (1). The overall prevalence of frailty in USA community dwelling aged 65 or older in the United States ranges 7-12%. The prevalence of frailty increased with age from 3.9% in the 65-74 age group to 25% in the 85+group, and was greater in women than men (8% vs. 5%) (2).

What are important topics for older adults to learn about to reduce their risk of becoming frail?

Aging is a universal phenomenon and humans are no exception. Gerontology deals with the psychological, social and biological aspects of aging process. A recent study shows that people aged 85 years and older are expected to augment from 5.3 million people to 21 million as the world reach 2050. In today’s world Gerontology has an enormous role to play so that the senior citizens could be analyzed and their needs may be addressed with compassion and empathy.

The purpose is to bring awareness of identifying and assessing frailty in the older population, which is required in being able to recognize those who may be at greatest risk for adverse health events. Assessment of frailty could provide an opportunity for subsequent planning of interventions; with the intention and real possibility of protecting the health and wellbeing of the older

Functional decline, in hospitalized elderly patients occurs at the time of admission. During admission for acute illness, elderly patients are not sometimes encouraged to get out of bed to ambulate within the unit. Instead, they remain in bed without any activity. (Convinsky, Palmer, Kresevic, Kahana, Counsell, & Fortinsky 2011). This inactivity tends to cause weakness and some other complications such as falls, malnutrition, loss of independence, increased risk of hospitalization, and depression.

The other challenging for healthcare providers and researchers in assessing frailty is that detecting the truly frail person based on specific context. Evidence from the Global Burden Diseases (GBD) report revealed that the dissimilar context or geographical areas show the different outcomes (GBD). Thus, the cultural sensitive frailty screening is needed in clinical settings. The existing frailty instruments concern multidimensional of frail person; evidently, the individuals’ difference plays the important roles in distinguishing frailty. Therefore, many studies focus on the individual factors–genetic/epigenetic, metabolic factors, environment, and lifestyle–to delineate frailty.(Aunan et al., 2016; Fulop et al., 2015; Morikawa et al., 2013;

A majority of frailty assessment used a single tool (Dasgupta et al., 2009; Kistler et al., 2015; Krishnan et al., 2014; Kua et al., 2016; Velanovich et al., 2013), while only one study utilized multiple tools for comparing to assess frailty (Hilmer et al., 2009). Frailty justification, most studies used