AN ELDERLY COMORBID PATIENT: PRIORITIZING

Population ageing phenomena is observed in most of the developed countries. According to the present criteria population ageing is determined by the percent of its citizens older than 65 years. Although the most rapidly increasing age group in the world includes people older than 80 years. By the midpoint of the century 1/5 of all the senior people in the world will be 80 years and older. It is well known that person’s health deteriorates with age as the age itself is a risk factor for many disorders. Most of the seniors have several chronic disorders, in other words are comorbid. The modern healthcare system is focused on treatment of one primary condition but when it comes to senior patients who have several severe chronic disorders at the same time this is not a preferable approach. Use of clinical approach with consideration of all existing pathologies as well as functional and cognitive abilities of senior people will be most appropriate in this case. It is determined that prognosis and quality of life of seniors depend not only on the amount of chronic disorders but also on the developed geriatric syndromes. Geriatric syndrome is a multifactor age-associated clinical condition that deteriorates the quality of life and increases risk of adverse outcomes such as hospital admission, loss of independence and death. Frequent geriatric syndromes include cognitive decline, depression, sensory deficits (vision and hearing loss), falls, edentulism (teeth loss), senile asthenia (SA) syndrome and others. In management of comorbid patients SA and patient’s life priorities should be considered. Treatment should be focused on increase of quality of life and support of patient’s independence in everyday life. When choosing therapy for patients with SA syndrome other existing geriatric syndromes should be considered as well as severity of cognitive decline that makes it difficult for the patients to use the medications correctly and decreases compliance. Treatment of cognitive disorders has two main aims: to slow the progression and decrease severity of existing disorder in order to increase the quality of life of patients and their relatives. The treatment should be aimed at the cause of the decline with consideration of comorbidity. Synthesis of neurotrophic factors and their receptors that can influence neurons’ survival is a natural brain defense mechanism that activates after the first minutes of damage. That explains the use of medications with neurotrophic action. Cerebrolysin is a peptidergic medication with proven in vitro and in vivo neurospecific neurotrophic action similar to action of native neurotrophic factors.

elderly patients, comorbidity, cognitive disorders, Cerebrolysin