[The need for a multidimensional assessment in frail patients]. / Notwendigkeit eines multidimensionalen Assessments bei Frailty.

A comprehensive geriatric assessment (CGA) encompasses medical, psychosocial, and functional aspects that facilitate comprehensive treatment planning and therapy for older adults. It goes beyond a simple screening and typically includes evaluating functionality, mobility, cognition, and emotions, with additional dimensions being relevant based on specific goals. In essence, CGA is suitable for recognizing and evaluating the complexity of frailty and devising suitable interventions.CGA represents a structured way to map the complexity of frail older adults. Employing a multidimensional strategy, it enables the early identification of frailty, facilitating tailored treatment plans, risk assessment and the monitoring of changes over time. A CGA can be conducted in different settings, including acute geriatric wards, in form of a consultation in non-geriatric wards, or directly in outpatient settings and has proven effective in improving care among frail patients.A recent trend in CGA programs involves the use of virtual assessments through telemedicine. Communication occurs via telephone or electronic health records, with each evaluation being checked by a physician. The latest evidence indicates substantial research potential in automated data collection and AI-driven analysis.

[Multimorbidity in patient's care - definitions, strategies and limitations]. / Multimorbidität im Versorgungsalltag ­ Definitionen, Strategien und Grenzen.

The challenge of multimorbidity, the occurrence of multiple medical conditions, lies in its complexity, considering their type and severity, their interactions, and the patient's social status and characteristics. Although the number of combinations appears unlimited, there emerge so-called multimorbidity patterns, that group diseases, that often coincide.The prevalence of multimorbidity will increase dramatically because of the demographic change and the medical progress, leading to exploding costs in healthcare. The definition and the therapeutic approaches of the field are ambiguous, while it also lacks an established assessment.The complex needs of a patient with multimorbidity are not addressed appropriately with the established one-disease-approach. Clinical guidelines can suggest conflicting treatment strategies, which result in decision dilemmas in daily work.Time, communication and decisions adapted to the patient's situation are the key to a successful treatment of multimorbidity. An integrated approach must be based on a comprehensive geriatric assessment. Action strategies and the integration of guidelines are needed and will support the clinician during the decision-making processes. Furthermore, clinical studies should include older adults with multimorbidity and should particularly consider their relevant outcomes.Geroscience is a new research area that addresses the hallmarks of aging with therapeutic approaches to delay or even avoid the onset of multimorbidity.