70860 - The Geriatric Patient: Pathophysiological Basis of Fragility

Learning outcomes

At the end of the course, the student: Knows the basic pathophysiological notions of frailty syndrome and its clinical repercussions on the elderly patient, with particular regard to the close interrelationship between frailty and drug therapies. They are able to use the diagnostic tools for the identification of frailty in various care settings, and to identify the most common problems of interaction between frailty and drugs in the individual patient. He/she knows the main criteria for an appropriate prescription of drugs in the elderly patient and the sources of documentation to support them. He/she is able to identify the most common problems of inappropriate prescribing in the individual patient.

Course contents

1. The elderly patient and the geriatric patient: the fragility syndrome
2. Pathophysiology of frailty: theoretical models
3. Role of sarcopenia in the frailty syndrome
4. Consequences of frailty in clinical practice
5. Frailty screening tools: generalities
6. The physical phenotype of frailty
7. The cumulative model
8. The frail elderly in the Emergency Department
9. Pharmacological issues specific to the elderly (pharmacokinetic and pharmacodynamic aspects)
10. Pathophysiological bases for an increased susceptibility of the elderly to adverse drug reactions
11. Drug risk management in the elderly
12. Criteria for assessing prescriptive appropriateness (Beers criteria and their evolution).

Readings/Bibliography

Geriatrics and Gerontology texts.
Texts of Pharmacology

Teaching methods

Lectures and interactive activity with clinical case presentations.

Assessment methods

Verification of learning through mutiple-answer quizzes on the topics covered at the end of each lesson.

Teaching tools

Powerpoint presentations that will be made available to students at the end of class.

Office hours

See the website of Marco Domenicali