ITA answers Ageing Week 2011

Station 1 Why does muscle strength decline with age? - an overall decrease in muscle mass - age-associated atrophy of muscle fibres (mostly type II fibres that provide explosive power) - Exacerbated by disuse

Station 1 Why is the loss in strength greater in the lower limbs? - Disuse tends to affect lower limbs more (a move from active to inactive leads to a much greater change in leg use than in arm use)

Station 1 Why are the male scores higher than the female scores? -Males have higher muscle mass -Driven by testosterone and genetics

Station 1 Is grip strength an objective measure? - Semi-objective. Effort, mood and motivation affect grip strength as well as muscle strength and pain / joint problems

Station 1 What factors influence how an individual scores? - Age, sex, genetics, training, effort all play a role

Station 2 What problems might muscle weakness produce for older people? - Muscle weakness leads to immobility, falls and dependence in older people.

Station 2 What clinical conditions can produce muscle weakness, other than sarcopenia of age? -Clinical conditions in old age causing muscle weakness include Parkinson's disease, myopathies (e.g. polymyositis), stroke, motor neurone disease, COPD, heart failure -and any condition that results in an older person becoming immobile (e.g. infection, injury).

Station 3 Why are older people reluctant to present with visual problems? - many older people believe that poor sight is an inevitable accompaniment of old age - many older people believe that "nothing can be done" - some old people think that "eyes are not the doctor's problem" - some old people fear that admitting to visual problems may lead to a forced move to institutional care

Station 3 What are the 3 impairments depicted? -Cataract - Age-related macular degeneration -Diabetic retinopathy

Station 4 Why does the amount of sway increase when you close your eyes? - visual cues are lost, and you rely solely on proprioception to maintain balance.

Station 4 What common conditions in old age affect balance? Parkinson's disease Drug side-effects e.g. phenytoin, diuretics, Stroke Muscle weakness (e.g. sarcopenia) Peripheral neuropathy (e.g. diabetes) Joint problems Ear problems (e.g. BPPV, Meniere’s disease) Any cause of impaired vision

Station 5 Why is it important to distinguish normal ageing from disease? -To avoid labelling treatable disease as being ‘just due to your age’ and hence denying effective intervention -To avoid inappropriate investigation and treatment of normal variance in older people

Station 5 Is the change in digit span of clinical importance? - No, as long as the normal range at a given age is known