老年医学与衰弱老年人的医疗服务

目的 随着年龄的增长.人们发生多种健康问题的可能性增大.这些问题可被称作健康缺陷.健康缺陷越多.越容易引发健康方面的不良后果,例如健康状况恶化,甚至死亡.所渭衰弱,是指能够增加不良健康后果的危险的身体状态.健康缺陷度越高,身体衰弱度就越大.在临床上,通过临床衰弱量表-09的使用,可以对衰弱度进行逐级描述(此量表是加拿大健康与衰老研究课题所设计使用的临床衰弱量表的修订版).衰弱导致了健康问题的复杂化.由于老年人的健康问题较为复杂,而临床服务一般只侧重于诊治单一的问题,造成对老年患者的服务不够全面.老年专科医生应该是能够综合处理复杂问题的专家,应擅长诊治并存多种健康问题的老年患者.充分了解和认真研究健康需求的复杂性问题,老年专科医生才能最有效地帮助那些身体衰弱的老年患者.模式识别就是对付老年疾病复杂性的一种重要手段,它借助于老年综合性评估和对实际发病的衰弱老年人所表现出的症状特征的识别而加以实现.

Geriatric medicine and the care of frail elderly people

Objective As people age, they are more likely to have things go wrong with them. The things that they have wrong with them can be called deficits. The more deficits that they have, the more susceptible they are to adverse health outcomes, such as worse health and even death. This state of increased risk of adverse health outcomes is known as frailty. The more deficits that people have, the frailer they are. Grades of frailty can be discerned clinically, using the Clinical Frailty Scale- 09, a revised version of the Canadian Study of Health and Aging Clinical Frailty Scale. With frailty comes complexity, and as older adults have complex problems, they are less well suited to clinical services which focus on only one problem. Geriatricians should be experts in managing complexity, i. e. , they need to be expert in managing people who have many active problems. Geriatricians best manage frail elderly patients by finding ways to embrace the complexity of their patients' needs. An important means of embracing complexity is through pattern recognition. This is facilitated by a Comprehensive Geriatric Assessment and by recognizing common disease presentations in frail elderly people who become acutely ill.