• Barbara Kumlehn, Letizia Ragazzoni, and Michael Denkinger.
• Geriatrisches Zentrum Ulm/Alb-Donau an der Agaplesion Bethesda Klinik Ulm.
• Dtsch. Med. Wochenschr. 2022 Nov 1; 147 (22): 1443-1449.

AbstractThe challenge of multimorbidity, the occurrence of multiple medical conditions, lies in its complexity, considering their type and severity, their interactions, and the patient's social status and characteristics. Although the number of combinations appears unlimited, there emerge so-called multimorbidity patterns, that group diseases, that often coincide.The prevalence of multimorbidity will increase dramatically because of the demographic change and the medical progress, leading to exploding costs in healthcare. The definition and the therapeutic approaches of the field are ambiguous, while it also lacks an established assessment.The complex needs of a patient with multimorbidity are not addressed appropriately with the established one-disease-approach. Clinical guidelines can suggest conflicting treatment strategies, which result in decision dilemmas in daily work.Time, communication and decisions adapted to the patient's situation are the key to a successful treatment of multimorbidity. An integrated approach must be based on a comprehensive geriatric assessment. Action strategies and the integration of guidelines are needed and will support the clinician during the decision-making processes. Furthermore, clinical studies should include older adults with multimorbidity and should particularly consider their relevant outcomes.Geroscience is a new research area that addresses the hallmarks of aging with therapeutic approaches to delay or even avoid the onset of multimorbidity.Thieme. All rights reserved.

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