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IMF-043-01-0001-en	Normal ageing narrows homeostatic range. Why, then, can chronological age not define an older person's physiological reserve?	How much reserve is actually lost is determined by disease, inactivity, nutrition, environment, and social conditions, so ageing is heterogeneous.	Integrated Medical Foundations; chapter 43, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2ee14ee68c74818ed1a84102ec62f2cf2cd3625ec4dba2c15435bd8f5185fc42; editorial review pending	imf lang::en chapter::043 module::043-01 review::pending
IMF-043-01-0002-en	Why does cardiovascular ageing reduce exercise reserve and increase orthostatic hypotension even when resting function seems adequate?	Adrenergic responsiveness, maximum heart rate, and baroreflex sensitivity decline, so the limitation is exposed only when stress demands compensation.	Integrated Medical Foundations; chapter 43, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2ee14ee68c74818ed1a84102ec62f2cf2cd3625ec4dba2c15435bd8f5185fc42; editorial review pending	imf lang::en chapter::043 module::043-01 review::pending
IMF-043-01-0003-en	How do age-related lung changes increase the risk of aspiration and infection?	Lungs lose recoil, chest-wall compliance, clearance, cough strength, and gas-exchange reserve, so material is cleared less effectively and infection is tolerated poorly.	Integrated Medical Foundations; chapter 43, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2ee14ee68c74818ed1a84102ec62f2cf2cd3625ec4dba2c15435bd8f5185fc42; editorial review pending	imf lang::en chapter::043 module::043-01 review::pending
IMF-043-01-0004-en	Why can a normal creatinine be misleading in an older person with reduced muscle mass?	Less muscle produces less creatinine, so a normal value can conceal low filtration.	Integrated Medical Foundations; chapter 43, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2ee14ee68c74818ed1a84102ec62f2cf2cd3625ec4dba2c15435bd8f5185fc42; editorial review pending	imf lang::en chapter::043 module::043-01 review::pending
IMF-043-01-0005-en	How do age-related changes in body composition and liver function alter the handling of water-soluble and lipid-soluble drugs?	Less body water and lean mass with more fat lets water-soluble drugs concentrate and lipid-soluble drugs persist; phase-one metabolism may decline while conjugation is better preserved.	Integrated Medical Foundations; chapter 43, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2ee14ee68c74818ed1a84102ec62f2cf2cd3625ec4dba2c15435bd8f5185fc42; editorial review pending	imf lang::en chapter::043 module::043-01 review::pending
IMF-043-01-0006-en	Processing speed and muscle power change with age. Which two conclusions must not be drawn from this?	That dementia is part of normal ageing, and that resistance training is no longer effective; both are false, and reserve varies greatly.	Integrated Medical Foundations; chapter 43, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2ee14ee68c74818ed1a84102ec62f2cf2cd3625ec4dba2c15435bd8f5185fc42; editorial review pending	imf lang::en chapter::043 module::043-01 review::pending
IMF-043-01-0007-en	What distinguishes the phenotype and accumulated-deficit concepts of frailty, and what do both predict?	The phenotype uses weakness, slow walking, low activity, exhaustion, and weight loss; deficits accumulate across disease, function, cognition, and social domains. Both predict falls, delirium, disability, institutionalisation, toxicity, and death.	Integrated Medical Foundations; chapter 43, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2ee14ee68c74818ed1a84102ec62f2cf2cd3625ec4dba2c15435bd8f5185fc42; editorial review pending	imf lang::en chapter::043 module::043-01 review::pending
IMF-043-01-0008-en	Why must a frailty score not be used to deny treatment automatically?	Frailty is dynamic and can improve with nutrition, rehabilitation, medication review, support, and treatment of reversible disease, so the question is whether benefit, burden, and recovery path fit this individual.	Integrated Medical Foundations; chapter 43, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2ee14ee68c74818ed1a84102ec62f2cf2cd3625ec4dba2c15435bd8f5185fc42; editorial review pending	imf lang::en chapter::043 module::043-01 review::pending
IMF-043-01-0009-en	In sarcopenia, why do strength and performance matter more than muscle mass, and what is central to treatment?	Sarcopenia is loss of strength with reduced quantity or quality, so function matters more than mass alone; progressive resistance exercise, adequate nutrition, and treating causes are central.	Integrated Medical Foundations; chapter 43, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2ee14ee68c74818ed1a84102ec62f2cf2cd3625ec4dba2c15435bd8f5185fc42; editorial review pending	imf lang::en chapter::043 module::043-01 review::pending
IMF-043-01-0010-en	How do basic and instrumental activities of daily living differ, and why is decline from baseline clinically important?	Basic activities cover self-care such as feeding, dressing, toileting, bathing, transfers; instrumental ones cover shopping, cooking, medicines, finances. Decline from baseline may be the most sensitive sign of illness.	Integrated Medical Foundations; chapter 43, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2ee14ee68c74818ed1a84102ec62f2cf2cd3625ec4dba2c15435bd8f5185fc42; editorial review pending	imf lang::en chapter::043 module::043-01 review::pending
IMF-043-01-0011-en	Why should caregivers be included in geriatric assessment, yet the patient also be spoken to privately?	Caregiver reports can clarify change, while speaking directly and privately to the patient protects autonomy and allows abuse or coercion to be detected.	Integrated Medical Foundations; chapter 43, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2ee14ee68c74818ed1a84102ec62f2cf2cd3625ec4dba2c15435bd8f5185fc42; editorial review pending	imf lang::en chapter::043 module::043-01 review::pending
IMF-043-01-0012-en	How may infection and myocardial infarction present atypically in older adults?	Infection may occur without fever or leukocytosis, and myocardial infarction may cause breathlessness, weakness, or confusion rather than pain; illness often appears as delirium, falls, or functional decline.	Integrated Medical Foundations; chapter 43, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2ee14ee68c74818ed1a84102ec62f2cf2cd3625ec4dba2c15435bd8f5185fc42; editorial review pending	imf lang::en chapter::043 module::043-01 review::pending
IMF-043-01-0013-en	Why should several modest insults not be dismissed when an older person becomes acutely confused?	Infection, constipation, sleep loss, unfamiliar surroundings, sedatives, and sensory impairment interact, so together they can cause severe delirium; new symptoms must not be attributed to age.	Integrated Medical Foundations; chapter 43, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2ee14ee68c74818ed1a84102ec62f2cf2cd3625ec4dba2c15435bd8f5185fc42; editorial review pending	imf lang::en chapter::043 module::043-01 review::pending
IMF-043-01-0014-en	What distinguishes delirium from dementia, and which form of delirium is most often missed?	Delirium is acute, fluctuating inattention caused by physiological disturbance, whereas dementia is chronic acquired decline interfering with independence; quiet hypoactive delirium is frequently missed.	Integrated Medical Foundations; chapter 43, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2ee14ee68c74818ed1a84102ec62f2cf2cd3625ec4dba2c15435bd8f5185fc42; editorial review pending	imf lang::en chapter::043 module::043-01 review::pending
IMF-043-01-0015-en	Why are antipsychotics not a treatment for delirium itself, and when may they be used?	They do not cure delirium, which requires treating the cause; they are reserved for selected severe distress or danger after non-drug measures, given cardiac, motor, stroke, and mortality risk.	Integrated Medical Foundations; chapter 43, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2ee14ee68c74818ed1a84102ec62f2cf2cd3625ec4dba2c15435bd8f5185fc42; editorial review pending	imf lang::en chapter::043 module::043-01 review::pending
IMF-043-01-0016-en	Why must cognitive test results in an older person be interpreted with caution?	Scores are influenced by education, culture, language, hearing, vision, pain, and fatigue, and depression can mimic or worsen cognitive impairment.	Integrated Medical Foundations; chapter 43, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2ee14ee68c74818ed1a84102ec62f2cf2cd3625ec4dba2c15435bd8f5185fc42; editorial review pending	imf lang::en chapter::043 module::043-01 review::pending
IMF-043-01-0017-en	Why does effective falls prevention combine several interventions rather than one?	Falls usually have multiple causes, so prevention combines strength and balance exercise, medication reduction, vision and footwear care, home modification, continence management, and treating cardiovascular or neurological causes.	Integrated Medical Foundations; chapter 43, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2ee14ee68c74818ed1a84102ec62f2cf2cd3625ec4dba2c15435bd8f5185fc42; editorial review pending	imf lang::en chapter::043 module::043-01 review::pending
IMF-043-01-0018-en	Why is a fall described as a syndrome rather than a diagnosis, and why does fear-driven inactivity matter?	A fall reflects underlying causes that must be investigated, including why the person could not get up; fear-driven inactivity worsens the risk of further falls.	Integrated Medical Foundations; chapter 43, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2ee14ee68c74818ed1a84102ec62f2cf2cd3625ec4dba2c15435bd8f5185fc42; editorial review pending	imf lang::en chapter::043 module::043-01 review::pending
IMF-043-01-0019-en	Why does appropriateness matter more than drug count in polypharmacy, and how does a prescribing cascade arise?	Following several disease guidelines can accumulate drugs whose combined burden exceeds benefit; a cascade occurs when an adverse effect is mistaken for a new disease and treated with another drug.	Integrated Medical Foundations; chapter 43, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2ee14ee68c74818ed1a84102ec62f2cf2cd3625ec4dba2c15435bd8f5185fc42; editorial review pending	imf lang::en chapter::043 module::043-01 review::pending
IMF-043-01-0020-en	Which drug classes carry increased pharmacodynamic sensitivity in older adults, and what practical factors also affect safety?	Sedatives, anticholinergics, opioids, anticoagulants, glucose-lowering and pressure-lowering drugs; interactions, duplicates, complex schedules, swallowing, cost, cognition, and dexterity also affect safety.	Integrated Medical Foundations; chapter 43, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2ee14ee68c74818ed1a84102ec62f2cf2cd3625ec4dba2c15435bd8f5185fc42; editorial review pending	imf lang::en chapter::043 module::043-01 review::pending
IMF-043-01-0021-en	Which medicines are prioritised for deprescribing, and why must some be tapered?	Drugs without indication, duplicates, those causing harm, preventive drugs whose time to benefit exceeds prognosis, and those inconsistent with goals; some need tapering to avoid withdrawal or rebound.	Integrated Medical Foundations; chapter 43, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2ee14ee68c74818ed1a84102ec62f2cf2cd3625ec4dba2c15435bd8f5185fc42; editorial review pending	imf lang::en chapter::043 module::043-01 review::pending
IMF-043-01-0022-en	Why is serum albumin not a standalone measure of nutrition, and what is assessed instead?	Albumin is altered by inflammation and hydration; weight trajectory, intake, muscle, function, oral health, and feeding support are assessed instead.	Integrated Medical Foundations; chapter 43, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2ee14ee68c74818ed1a84102ec62f2cf2cd3625ec4dba2c15435bd8f5185fc42; editorial review pending	imf lang::en chapter::043 module::043-01 review::pending
IMF-043-01-0023-en	Why do indwelling catheters rarely solve chronic incontinence?	They create infection and trauma; chronic incontinence arises from urge, stress, overflow, functional, or mixed mechanisms that bladder diaries, residual measurement, and examination should identify.	Integrated Medical Foundations; chapter 43, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2ee14ee68c74818ed1a84102ec62f2cf2cd3625ec4dba2c15435bd8f5185fc42; editorial review pending	imf lang::en chapter::043 module::043-01 review::pending
IMF-043-01-0024-en	What must be done before concluding that an older person lacks capacity, and why is an unwise decision not enough?	Support communication, treat delirium, optimise hearing and vision, use interpreters, and simplify information; capacity depends on understanding, retaining, weighing, and communicating, not on the choice being wise.	Integrated Medical Foundations; chapter 43, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 2ee14ee68c74818ed1a84102ec62f2cf2cd3625ec4dba2c15435bd8f5185fc42; editorial review pending	imf lang::en chapter::043 module::043-01 review::pending