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Start low, go slow, but look far: the case of geriatric medicine in Balkan countries

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Key summary points

AbstractSection Aim

To briefly present the current situation regarding Geriatric Medicine in Balkan countries and discuss possible perspectives of development by exchange and interaction with countries with more developed Geriatric Medicine.

AbstractSection Findings

Balkan countries seem to encounter similar difficulties and share common challenges regarding under- and post-graduate education in geriatric medicine, accessibility to comprehensive geriatric assessment and response to special needs of older people in various clinical settings. Proposed solutions need to be pragmatic, effective, applicable in harmony with available services and adjusted to each country’s special context.

AbstractSection Message

InterEuropean networking, cooperation among countries under the auspices of EuGMS, and suitable application of experience from countries with developed Geriatrics, could contribute to the development of Geriatric Medicine in Balkan countries as well.

Abstract

Purpose

To present an insight of the situation of geriatric medicine in Balkan countries, as it was presented in the context of the 2nd pre-congress seminar of the 16th European Geriatric Medicine Society (EuGMS) Congress Athens 2021.

Methods

Representatives from 8 Balkan countries (Albania, Croatia, Greece, Republic of North Macedonia, Romania, Serbia, Slovenia, Turkey) answered 3 questions to reflect the state of geriatric medicine in their country: education on geriatrics; systems/methods for assessment of functional status and frailty; pre-operative risk assessment. An open discussion followed.

Results

Undergraduate education in geriatric medicine seems underestimated in medical faculties of Balkan countries, whereas a high heterogeneity is observed at a post-graduate level. Only a few Balkan countries have geriatric medicine as a recognized medical specialty or subspecialty. Functional status and frailty are only sporadically assessed, and pre-operative risk assessment is very rarely performed with a geriatric focus. Scarcity of expertise and structures relevant to geriatric medicine seems to be common. Developing a training curriculum and geriatrics-related structures are two interconnected aspects. Cooperation among physicians and multidisciplinary teams are essential for the practice of geriatric medicine. A functional geriatric network is eventually necessary and ambulatory geriatric expertise is probably a feasible and clinically relevant starting point. Providing pragmatic solutions to the pressing challenges in variable clinical settings, supplementing and working in harmony with existing components of each health system, is probably the most convincing strategy to gain political support in developing geriatric medicine.

Conclusion

Balkan countries share common experiences and challenges in developing geriatrics. Whilst the principles of geriatric medicine are perhaps universal, proposed solutions should be adapted to each country’s specific circumstances. Cooperation of the Balkan countries could promote in each the development of geriatric medicine. EuGMS is willing to foster relevant actions.

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Acknowledgments

Authors thank Dr. George Soulis and Dr Christina Avgerinou for their contribution to the preparation of the Greek presentation and Dr. Lidija Pavleska and Dr. Pavlinka Milosavljevic for their contribution to the presentation of North Macedonia.

Funding

Not applicable.

Author information

Authors and Affiliations

  1. Université de Lorraine, CHRU-Nancy, Pôle « Maladies du Vieillissement, Gérontologie et Soins Palliatifs », 54000, Nancy, France

    Marina Kotsani & Athanase Benetos

  2. Department of Neurology, University of Patras, Patras, Greece

    John Ellul

  3. Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Istanbul, Turkey

    Gülistan Bahat

  4. Senior Consultant in Geriatric, Croatian Ministry of Health, Zagreb, Croatia

    Nenad Bogdanovic

  5. Theme Aging, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden

    Nenad Bogdanovic

  6. Faculty of Medicine, University of Medicine, Tirana, Albania

    Genc Burazeri

  7. Faculty of Medicine, Department of Geriatrics, “Zvezdara” University Hospital, University of Belgrade, Belgrade, Serbia

    Predrag Erceg

  8. Department of Geriatric, PHI Specialized Hospital for Geriatric and Palliative Medicine 13 November, Skopje, Republic of North Macedonia

    Biljana Petreska-Zovic

  9. University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania

    Gabriel Ioan Prada

  10. National Institute of Gerontology and Geriatrics “Ana Aslan”, Bucharest, Romania

    Gabriel Ioan Prada

  11. Laboratory of Primary Health Care, General Practice and Health Services Research-Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Emmanouil Smyrnakis

  12. Centre for Geriatric Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia

    Gregor Veninšek

  13. Emeritus Professor of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Chrysanthos Zamboulis

  14. Kings College London, London, UK

    Finbarr C. Martin

  15. Department of Geriatrics, Ghent University Hospital and Ghent University, Ghent, Belgium

    Mirko Petrovic

Authors
  1. Marina Kotsani
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  2. John Ellul
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  3. Gülistan Bahat
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  13. Mirko Petrovic
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  14. Athanase Benetos
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Corresponding author

Correspondence to Marina Kotsani.

Ethics declarations

Conflict of interest

MK, JE, ES and CZ declare no conflict of interest. NB, GB, PE, BPZ, GIP, GV, FCM, MP et AB declare no conflict of interest other than being funded by the EuGMS for their attendance to the Symposium. GB declares having received financial support for symposia/educational programs or given lectures arranged by or Abbott, Astellas, Lilly, Nestle, and Nutricia, along with her attendance to the Symposium also being funded by the EuGMS.

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Kotsani, M., Ellul, J., Bahat, G. et al. Start low, go slow, but look far: the case of geriatric medicine in Balkan countries. Eur Geriatr Med 11, 869–878 (2020). https://doi.org/10.1007/s41999-020-00350-x

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