Concurrent Health Problems Take Heavy Toll on Seniors

New diagnoses of common health problems add complexity to an older person's health status, which is usually characterized by preexisting problems. In 1999, 24 percent of Medicare beneficiaries age 65 or older had four or more chronic conditions. The proportion was 31.4 percent among those 85 or older.

The authors outline a need to improve the understanding of the role of multiple comorbid conditions in the health of older adults. A comprehensive nosology, or classification, of comorbidity is their first step towards this goal.

The nosology begins with physiologic systems (e.g., cardiovascular, endocrine) and assesses each system in several domains (e.g., coronary blood flow, systemic blood pressure, and cardiac function in the cardiovascular system). Functioning in each domain can range from high-functioning, even protective, zones (e.g., high levels of high-density-lipoprotein cholesterol) to severe dysfunction (as in end-stage disease).-The Gerontological Society of America