Acopia

Original Editor - Alex Palmer

Top Contributors - Alex Palmer, Kim Jackson, Lucinda hampton, Lauren Lopez, Chrysolite Jyothi Kommu, Chelsea Mclene, Mohamed A Hassanin, Aminat Abolade and Mohit Chand

Introduction

Frail elderly person

The word 'acopia' is often used to describe a patient’s inability to cope with activities of daily living. This term is disrespectful, implying fault on the part of the patient. Such patients are likely to have frailty with co-morbidities and have an acute (potentially reversible) illness. Older people living with frailty should be assessed using the principles of Comprehensive Geriatric Assessment, informed by an understanding of the concept of frailty and of geriatric syndromes, for example, falls and delirium.

• The term 'Acopia' may bias clinicians thought processes and cause diagnosis to be missed and reversible pathology to be underdiagnosed.
• The term is not helpful, it inaccurately implies that no active acute problems and does not recognize the presence of geriatric syndromes
• A study carried out within an NHS District General Hospital found that nearly half of patients described as having ‘Acopia’ presented with geriatric syndromes, such as falls, immobility and confusion. The authors argued that the definition of Acopia should be an inclusive term to describe the elderly patient having frailty with multiple medical problems, enabling health professionals to identify when specialist intervention is needed within the multi-disciplinary team.

Viewing

This 6 minute video highlights the negative aspects of using Acopia as a word.

Relation to Falls in Geriatrics

Natural loss of muscle mass may lead to loss of balance and coordination during ADLs (especially pulling, pushing and rising from chair) thus, affecting gait and increasing the risk of recurrent falls in older adults. These reported activities are associated with significant muscle power from extremities and preservation of COG within Base of support. Therefore, when balance and muscle mass are declined as noticed among geriatrics, these ADLs become difficult, especially rising from a chair in which the increase of the risk of all falls is noticed by 41% among older adults in nursing homes.