title: The geriatric management of frailty as paradigm of "The end of the disease era".
abstract: The sustainability of healthcare systems worldwide is threatened by the absolute and relative increase in the number of older persons. The traditional models of care (largely based on a disease-centered approach) are inadequate for a clinical world dominated by older individuals with multiple (chronic) comorbidities and mutually interacting syndromes. There is the need to shift the center of the medical intervention from the disease to the biological age of the individual. Thus, multiple medical specialties have started looking with some interest at concepts of geriatric medicine in order to better face the increased complexity (due to age-related conditions) of their average patient. In this scenario, special interest has been given to frailty, a condition characterized by the reduction of the individual's homeostatic reserves and increased vulnerability to stressors. Frailty may indeed represent the fulcrum to lever for reshaping the healthcare systems in order to make them more responsive to new clinical needs. However, the dissemination of the frailty concept across medical specialties requires a parallel and careful consideration around the currently undervalued role of geriatricians in our daily practice.
authors.affiliation: Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; Université de Toulouse III Paul Sabatier, Toulouse, France. Electronic address: macesari@gmail.com.
authors.forename: Matteo
authors.initials: M
authors.lastname: Cesari
authors.affiliation: Department of Geriatrics, Neurosciences, and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Marzetti
authors.affiliation: Department of Geriatrics, Marien Hospital Herne, University of Bochum, Bochum, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Thiem
authors.affiliation: Clinical and Epidemiological Research Department, National Geriatric Institute, Mexico City, Mexico.
authors.forename: Mario Ulises
authors.initials: MU
authors.lastname: Pérez-Zepeda
authors.affiliation: Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
authors.forename: Gabor
authors.initials: G
authors.lastname: Abellan Van Kan
authors.affiliation: Department of Geriatrics, Neurosciences, and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Landi
authors.affiliation: Department of Geriatrics, Ghent University Hospital, Ghent, Belgium.
authors.forename: Mirko
authors.initials: M
authors.lastname: Petrovic
authors.affiliation: Geriatrics and Geriatric Emergency Care, IRCCS-INRCA, Ancona, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cherubini
authors.affiliation: Department of Geriatrics, Neurosciences, and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bernabei
mesh_terms: D000368:Aged; D002983:Clinical Competence; D015897:Comorbidity; D019033:Delivery of Health Care, Integrated / Q000592:standards*; D016330:Frail Elderly / Q000706:statistics & numerical data*; D015577:Geriatric Assessment / Q000379:methods*; D005853:Geriatrics / Q000592:standards*; D006801:Humans
keywords: Aging; Comprehensive geriatric assessment; Frailty; Geriatrics; Multi-morbidity