Geriatric Skilled Nursing Department, Herzog Hospital, Jerusalem, Israel.
Hebrew University of Jerusalem, Jerusalem, Israel.
Front Public Health. 2021 Oct 12;9:513557. doi: 10.3389/fpubh.2021.513557. eCollection 2021.
Older adulthood encompasses several decades of change and heterogeneity. Primary care providers need a geriatric comprehensive vision for defining older adult subpopulations. Using PubMed and Google searches, we reviewed the literature on epidemiology of age-related physiological changes, age-related diseases and geriatric syndromes, functional state, and emotional and social changes. We divided old age into strata based on chronological age and strata based on functional state, disease burden, and geriatric syndromes. We describe 4 chronological-age strata beginning at age 60, and 4 functional-age strata based on frailty according to a modified clinical frailty scale. We provide clinical considerations and anticipatory guidance topics for each of the age strata and functional strata. Chronological age, functional status, chronic disease burden and geriatric syndromes, and life expectancy are all important domains that impact clinical care and appropriate anticipatory guidance for individual older adults. Better knowledge for differentiating subpopulations of older adults may improve clinical care, reduce medical overuse, improve personalized anticipatory guidance, and focus on the impact of functional state on the quality of life.
中老年阶段涵盖了几十年的变化和异质性。初级保健提供者需要对老年亚人群进行全面的老年综合评估。我们使用 PubMed 和 Google 搜索，回顾了与年龄相关的生理变化、与年龄相关的疾病和老年综合征、功能状态以及情感和社会变化的流行病学文献。我们根据年龄和功能状态、疾病负担和老年综合征将老年分为不同的层次。我们根据修改后的临床虚弱量表，描述了从 60 岁开始的 4 个年龄层次，以及基于虚弱程度的 4 个功能年龄层次。我们为每个年龄层次和功能层次提供了临床注意事项和预期指导主题。年龄、功能状态、慢性疾病负担和老年综合征以及预期寿命都是影响临床护理和个体化老年患者预期指导的重要领域。更好地了解老年人群的亚群可能会改善临床护理，减少医疗过度使用，改善个性化预期指导，并关注功能状态对生活质量的影响。
