Aging Clinical and Experimental Research

, Volume 25, Issue 6, pp 703–705

Guidelines for elderly patients with multimorbidity: how to cope with a dark night without fear

Point of View


The epidemiological transition has produced a society with a growing number of the elderly affected by multiple chronic diseases which often requires polypharmacy. Despite being the main users of medications, the elderly are largely underrepresented in clinical trials, especially if they have multimorbidity. It follows that the results of these trials are not applicable in the real world and potentially harmful. In order to breach the wall of this complexity, several suggestions have been put forward, from new clinical trial methodology, simulation models, and the use of patient-centered as opposed to disease-centered indicators. It is likely that comparative effectiveness research will accelerate the shift toward a focus on “universal” outcomes on which all diseases exert an effect. I believe that there is no “one-size-fits-all” solution in this area, but two ideas come to my mind. Why do we not invest more in educating our future geriatricians? And why do we not invest in public awareness campaigns?


Guidelines Multimorbidity Elderly people 


  1. 1.
    Marengoni A, Angleman S, Melis R et al (2011) Aging with multimorbidity: a systematic review of the literature. Ageing Res Rev 10:430–439PubMedCrossRefGoogle Scholar
  2. 2.
  3. 3.
    Tinetti ME, Studenski SA (2011) Comparative effectiveness research and patients with multiple chronic conditions. N Engl J Med 364:2478–2481PubMedCrossRefGoogle Scholar
  4. 4.
    American Geriatrics Society Expert Panel on the Care of Older Adults with Multimorbidity (2012) Patient-centered care for older adults with multiple chronic conditions: a stepwise approach from the American Geriatrics Society: American Geriatrics Society Expert Panel on the Care of Older Adults with Multimorbidity. J Am Geriatr Soc 60:1957–1968CrossRefGoogle Scholar
  5. 5.
    Campbell JY, Durso SC, Brandt LE, Finucane TE, Abadir PM (2012) The unknown profession: a geriatrician. J Am Geriatr Soc 61:447–449Google Scholar

Copyright information

© Springer International Publishing Switzerland 2013

Authors and Affiliations

  1. 1.Department of Clinical and Experimental ScienceUniversity of BresciaBresciaItaly
  2. 2.Geriatric Unit, Civili HospitalBresciaItaly

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