Geriatric Medicine
AKT High-Yield Breakdown
Geriatric medicine encompasses frailty, falls, delirium, dementia, polypharmacy, incontinence, and end-of-life care. The AKT tests the clinical tools used to assess older patients, the drugs most likely to cause harm, and the ethical and legal frameworks around capacity and advance care planning.
What You'll Learn
Learn the Clinical Frailty Scale, the STOPP/START prescribing criteria, the delirium versus dementia distinction, NICE dementia pharmacotherapy, falls risk assessment, and the legal framework for DNACPR and Lasting Power of Attorney.
Practise Geriatric Medicine MCQs
From the Clinical Frailty Scale and STOPP/START criteria to delirium versus dementia, Lewy body antipsychotic contraindications, and DNACPR legal framework — tackle focused MCQs across the full Geriatric Medicine curriculum.
Frailty and Comprehensive Geriatric Assessment
Frailty is a state of increased vulnerability to stressors due to diminished physiological reserve. It is not synonymous with old age, disability, or comorbidity — though these often coexist.
Clinical Frailty Scale (CFS)
CFS 1–3: fit to managing well (no frailty); CFS 4: vulnerable; CFS 5–6: mild to moderate frailty; CFS 7–8: severe to very severe frailty; CFS 9: terminally ill. A CFS ≥5 triggers frailty interventions in NICE guidance.
- Fried phenotype (5 domains): unintentional weight loss, exhaustion, weakness (grip strength), slow gait speed, low physical activity — 3+ = frail; 1–2 = pre-frail
- PRISMA-7 questionnaire: simple 7-item self-reported tool for identifying frailty in community settings
- Comprehensive Geriatric Assessment (CGA): structured multi-domain evaluation covering medical, functional, cognitive, psychological, social, and environmental factors; associated with reduced hospital admissions and improved outcomes
- Electronic Frailty Index (eFI): calculated from primary care records; score ≥0.25 = moderate frailty, ≥0.36 = severe frailty; used for case-finding in GP systems
Interventions
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