Situaciones clínicas de alta complejidad en el adulto mayor. Apoyo a la toma de decisiones

Abstract

Population aging has increased the prevalence of chronic diseases in older adults. This leads to significant clinical complexity and is associated with a greater risk of adverse effects, functional decline, hospitalizations, and mortality. Treatment objectives must be based on the patient's functional, cognitive, and social status as well as their preferences, prioritizing quality of life and the preservation of autonomy over long-term preventive goals of uncertain benefit. Polypharmacy is a key risk factor, making it essential to systematically review medication using validated tools such as the STOPP/START, Beers, and STOPP-Frail criteria.

Highly complex clinical situations common in geriatrics are reviewed, through a comprehensive geriatric assessment. Current evidence supports the idea that these strategies reduce adverse events, hospitalizations, and treatment toxicity without compromising survival and improve functional outcomes and quality of life. Care for older patients with chronic diseases must be based on multidisciplinary coordination; advance planning regarding decisions; and the integration of geriatric, palliative, and social care. This is a fundamental pillar of healthcare systems facing the challenge of an aging population.

.