Advertisement

Agreement between diseases-centered and multidimensional models of care in disadvantaged settings

Published:April 04, 2018DOI:https://doi.org/10.1016/j.ejim.2018.03.014
      The concept of disease has traditionally been representing the main focus of medicine and center of care. In fact, the clinical decision process largely relies on the diagnosis, treatment, and prevention of the individual's nosological conditions [
      • Tinetti M.E.
      • Fried T.
      The end of the disease era.
      ]. Nowadays, such paradigm tends to growingly seem inadequate. In fact, the aging of the population renders quite unusual the manifestation of a standalone disease, whereas the condition of multimorbidity (i.e., the co-occurrence of multiple diseases in one same person) becomes the normality [
      • Vetrano D.L.
      • Calderón-Larrañaga A.
      • Marengoni A.
      • Onder G.
      • Bauer J.M.
      • Cesari M.
      • et al.
      An international perspective on chronic multimorbidity: approaching the elephant in the room.
      ].
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to European Journal of Internal Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Tinetti M.E.
        • Fried T.
        The end of the disease era.
        Am J Med. 2004; 116: 179-185
        • Vetrano D.L.
        • Calderón-Larrañaga A.
        • Marengoni A.
        • Onder G.
        • Bauer J.M.
        • Cesari M.
        • et al.
        An international perspective on chronic multimorbidity: approaching the elephant in the room.
        J Gerontol A Biol Sci Med Sci. Sep 16 2017; https://doi.org/10.1093/gerona/glx178
        • Cesari M.
        • Pérez-Zepeda M.U.
        • Marzetti E.
        Frailty and multimorbidity: different ways of thinking about geriatrics.
        J Am Med Dir Assoc. 2017; 18: 361-364
        • Rockwood K.
        • Mitnitski A.
        Frailty in relation to the accumulation of deficits.
        J Gerontol A Biol Sci Med Sci. 2007; 62: 722-727
        • Albania Overview [Internet]
        (cited 2017 Jul 31. Available from)
        • Searle S.D.
        • Mitnitski A.
        • Gahbauer E.A.
        • Gill T.M.
        • Rockwood K.
        A standard procedure for creating a frailty index.
        BMC Geriatr. 2008; 8: 24
        • Rockwood K.
        • Andrew M.
        • Mitnitski A.
        A comparison of two approaches to measuring frailty in elderly people.
        J Gerontol A Biol Sci Med Sci. 2007; 62: 738-743
        • Gray W.K.
        • Orega G.
        • Kisoli A.
        • Rogathi J.
        • Paddick S.-M.
        • Longdon A.R.
        • et al.
        Identifying frailty and its outcomes in older people in rural Tanzania.
        Exp Aging Res. 2017; 43: 257-273
        • Ha N.T.
        • Le N.H.
        • Khanal V.
        • Moorin R.
        Multimorbidity and its social determinants among older people in southern provinces, Vietnam.
        Int J Equity Health. 2015; 14: 50
        • Fried L.P.
        • Ferrucci L.
        • Darer J.
        • Williamson J.D.
        • Anderson G.
        Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care.
        J Gerontol A Biol Sci Med Sci. 2004; 59: 255-263