Frailty as a breakthrough point for multimorbidity management among older adults: challenges and opportunities in China

The BMJ Pub Date : 2024-10-18 DOI:10.1136/bmj-2023-076767

Xunliang Tong, Jian Xu, Enying Gong, Xinyue Zhang, Yanming Li, Ruitai Shao, Huan Xi

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Abstract

Huan Xi and colleagues argue that tailored strategies are needed to seamlessly integrate frailty assessment into multimorbidity management, thereby promoting a shift towards a health oriented management approach The global population is undergoing a profound demographic transition characterised by a substantial increase in both the absolute number and the proportion of older people. China’s ageing population has been especially in the spotlight. One recent projection suggests a twofold escalation in the percentage of people aged 60 years and older in China—an increase from 168 million people, 12.4% of the entire population, in 2010 to 402 million, 28% of the population, by 2040.1 As people age, the risk of functional decline and multimorbidity increases. Multimorbidity, defined by the World Health Organization as the concurrent presence of two or more chronic conditions in an individual,2 affects a significant proportion of the global population at a pooled prevalence of 42.4%.3 This prevalence increases markedly with age, ranging from 30% among middle aged people to 82% among those aged 85 and above.4 In addition to multiple chronic conditions, frailty poses another concern for the older population. According to WHO, frailty is characterised as a clinically recognisable state with increased vulnerability resulting from age associated declines in physiological reserve and function across multiple organ systems.5 A recent review, synthesising data from 240 studies in 62 countries and territories, reported a global weighted prevalence of frailty of 10.7% among people aged 65 and over.6 Both multimorbidity and frailty affect the health of the older population in China, emphasising the importance of improving their health status in addition to multimorbidity management. Thus, to tackle the growing challenge of multimorbidity, this analysis highlights the importance of considering frailty as a critical breakthrough point for multimorbidity management; describes the current global landscapes of …

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将虚弱作为老年人多病管理的突破点：中国的挑战与机遇

Huan Xi 及其同事认为，需要制定有针对性的策略，将虚弱评估与多病管理无缝结合，从而促进向以健康为导向的管理方法转变。全球人口正在经历深刻的人口结构转型，其特点是老年人的绝对数量和比例都在大幅增加。中国的人口老龄化问题尤其受到关注。最近的一项预测显示，中国 60 岁及以上人口的比例将增加两倍，从 2010 年的 1.68 亿人（占总人口的 12.4%）增加到 2040 年的 4.02 亿人（占总人口的 28%）。世界卫生组织将多病症定义为一个人同时患有两种或两种以上的慢性疾病，2 这种疾病在全球人口中占有相当大的比例，总患病率为 42.4%。3 随着年龄的增长，患病率明显上升，从中年人的 30%到 85 岁及以上老年人的 82%。根据世界卫生组织的定义，虚弱是一种临床上可识别的状态，其特征是与年龄相关的生理储备和多个器官系统功能的衰退导致脆弱性增加。5 最近的一项综述综合了 62 个国家和地区 240 项研究的数据，报告称全球 65 岁及以上人群的加权虚弱患病率为 10.7%。因此，为了应对日益严峻的多病症挑战，本分析报告强调了将虚弱作为多病症管理的关键突破点的重要性；描述了当前全球多病症管理的现状，并提出了一些建议。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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The BMJ

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