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Frailty and Failure to Thrive Christopher Taylor, D.O. M.P.H. W. R. Bohon Senior Health Clinic R. J. Reynolds Elder Care Facility Bartlesville, Oklahoma.

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Presentation on theme: "Frailty and Failure to Thrive Christopher Taylor, D.O. M.P.H. W. R. Bohon Senior Health Clinic R. J. Reynolds Elder Care Facility Bartlesville, Oklahoma."— Presentation transcript:

1 Frailty and Failure to Thrive Christopher Taylor, D.O. M.P.H. W. R. Bohon Senior Health Clinic R. J. Reynolds Elder Care Facility Bartlesville, Oklahoma

2 Frailty Frailty Multidimensional syndrome of loss of reserves – Energy – Physical Strength – Cognition – Health

3 Rockwood, K. et al. CMAJ 2005;173:

4 Clinical Definitions 3 of 5 attributes – unintentional weight loss – muscle weakness – slow walking speed – exhaustion – low physical activity

5 Copyright ©2005 CMA Media Inc. or its licensors Rockwood, K. et al. CMAJ 2005;173:

6 Frailty Incidence by Age Boyd CM - Am J Med - 01-NOV-2005; 118(11):

7 Development of Dependency Boyd CM - Am J Med - 01-NOV-2005; 118(11): Percent developing dependence in activities of daily living at 18 months, stratified by hospitalization and frailty status.

8 Rockwood, K. et al. CMAJ 2005;173: Fig. 1: Kaplan-Meier curves, adjusted for age and sex, for study participants (n) over the medium term (5-6 years), according to their scores on the CSHA Clinical Frailty Scale

9 Failure to thrive Decrease in vitality – Progressive loss Physical Functioning Weight Lean Body Mass – Poor nutrition /Dehydration – Inactivity – Impaired immune response

10 Frailty and FTT Organic causes – Malignancy – Chronic Infectious Disease – Chronic Inflammatory Condition – Endocrine Disorder – Organ Failure

11 Frailty and FTT Nonorganic causes – Medication effects Anticholinergics Antiepileptics Benzodiazepines / Neuroleptics Beta Blockers and Central alpha blockers Diuretics Corticosteroids Opioids SSRIs / TCAs – Polypharmacy

12 Frailty and FTT Functional problems – Arthritis – Neuromuscular – Neurologic – Dental

13 Frailty and FTT Psychosocial – Depression – Alcohol / Substance Use – Poverty – Social Isolation

14 Frailty and FTT Evaluation – Medical evaluation – Laboratory / Radiographic Chemistry, CBC, ESR, CRP, TSH – Functional Evaluation ADL, IADL – Social History support systems, financial status

15 Treatment Frailty – Exercise Prescription – Hormonal Therapy? GHRH IGF-1 Androgens

16 Treatment Failure to Thrive – Manage Identified Clinical Illness – Aggressive Nutritional Support – Psychosocial Supports – End of Life Care Discussions


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