- Understanding the role of aging in the management of chronic diseases
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Hidenori Arai
2022 ; 2022(1):
- 논문분류 :
- 춘계학술대회 초록집
Growing older populations are an increasingly serious health and socioeconomic concern for most modern societies. With the increase of the life expectancy, the incidence of chronic diseases, such as chronic kidney disease has also increased and older people tend to face increased risks for multimorbidities and disability. However, the traditional disease-oriented model of healthcare may not be inappropriate to address the needs of older people. As such greater attention should be given to strategies that promote healthy aging. Although aging is the common cause of all age-related diseases, aging in itself cannot be considered a disease. Because aging is the major risk factor for chronic diseases, we should be able to decrease the occurrence by influencing the aging process. The understanding of aging as a process should transform our approach towards practical methods for maintaining health throughout the lifespan. However, aging of biological systems occurs in numerous complex pathways. To deal with the complexity of the aging process the frailty concept has been introduced in geriatrics. Frailty is a geriatric syndrome in which the gradual decline of an individual's physiological system makes the individual more susceptible to stressors and increases the risk of adverse health outcomes. Additionally, frailty is a condition that appears before the onset of disability. As a novel concept, intrinsic capacity has also been introduced, but it has plenty of distinctions as well as commonalities and connections with frailty. As we age, we are at risk of experiencing a decline in our intrinsic capacity and deteriorations in our functional ability. Early markers of decline in intrinsic capacity and frailty, such as slow gait speed or low muscle strength, are often not identified by healthcare workers due to a lack of understanding of geriatrics. This can result in missed opportunities to reverse or delay declines through appropriate monitoring and interventions. Intrinsic capacity and frailty can be viewed as two sides of the same coin, where the former is an individual’s reserve of ability, whereas the latter a hindrance that grows with aging. WHO issued the ICOPE guidelines and handbook to aid primary healthcare workers, who provide care for older adults, using recommendations for the management and care of decline in intrinsic capacity, as well as a care pathway for identifying and screening intrinsic capacity to assess, manage, and provide appropriate support to caregivers. In my presentation I will address the importance of frailty and intrinsic capacity to manage older patients with multimorbidities.