Fried Linda P, Ferrucci Luigi, Darer Jonathan, Williamson Jeff D, Anderson Gerard
Department of Medicine, The Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, MD 21205, USA.
J Gerontol A Biol Sci Med Sci. 2004 Mar;59(3):255-63. doi: 10.1093/gerona/59.3.m255.
Three terms are commonly used interchangeably to identify vulnerable older adults: comorbidity, or multiple chronic conditions, frailty, and disability. However, in geriatric medicine, there is a growing consensus that these are distinct clinical entities that are causally related. Each, individually, occurs frequently and has high import clinically. This article provides a narrative review of current understanding of the definitions and distinguishing characteristics of each of these conditions, including their clinical relevance and distinct prevention and therapeutic issues, and how they are related. Review of the current state of published knowledge is supplemented by targeted analyses in selected areas where no current published data exists. Overall, the goal of this article is to provide a basis for distinguishing between these three important clinical conditions in older adults and showing how use of separate, distinct definitions of each can improve our understanding of the problems affecting older patients and lead to development of improved strategies for diagnosis, care, research, and medical education in this area.
共病，即多种慢性疾病、衰弱和残疾。然而，在老年医学领域，越来越多的人达成共识，认为这些是具有因果关系的不同临床实体。它们各自都很常见，且在临床上具有重要意义。本文对目前对这些病症各自的定义和区别特征的理解进行了叙述性综述，包括它们的临床相关性、独特的预防和治疗问题，以及它们之间的关系。在目前尚无已发表数据的选定领域进行有针对性的分析，对已发表知识的现状进行了补充。总体而言，本文的目的是为区分老年人这三种重要临床病症提供依据，并展示如何对每种病症使用单独、明确的定义来增进我们对影响老年患者问题的理解，并促使制定该领域更好的诊断、护理、研究和医学教育策略。
