老年共病——老年医学的机遇和挑战

《2010年第六次全国人口普查主要数据公报》显示，我国60岁及以上老年人数接近1．78亿（13％o衰老是很多慢性疾病的独立危险因子。流行病学研究显示50％以上的老年人患有3种以上的慢性疾病且存在鲜明的个体特征。老年共病概念的提出，意味着老年医学的临床工作重点已经由针对疾病的传统亚专科诊疗模式转向整合医学的综合评价及综合治疗。2012年美国老年医学会（AmericanGeriatricsSociety，ACS）提出了以患者为中心、针对有多种慢性问题的老年共病患者的诊治策略。本述评针对老年共病的基础、进展、综合评估和管理进行了系统阐述。

Geriatric multimorbidity--chance and challenge for geriatrics

According to the data from the sixth nationwide population census, 178 million people in China （13%） were over 60 years old in 2010. Aging is an independent risk factor for many chronic diseases. Epidemiological studies show that more than 50% of the elderly have 3 or more chronic diseases with distinct characteristics. The concept of geriatric multimorbidity indicates that the clinical focus of geriatrics has shifted from the traditional model of subspecialties to the integrative medicine which include comprehensive evaluation and treatment. In 2012, the American Geriatrics Society （ACS） provided the stepwise patient-centered care approach for diagnosis and treatment of older adults with multiple chronic conditions. This review aimed to describe the basement, development, comprehensive evaluation, and management system of geriatric multimorbidity.