European Respiratory Society Monograph, Vol. 43. 2009
The world population is rapidly ageing. As a consequence, the portion of the elderly burdened with polipathology and disability will grow, while economic resources to support it will shrink, due to the contraction of the working force. This will require a long-term preventive political strategy but there are also selected healthcare interventions that can be easily implemented to decrease the negative impact of this demographic trend on the well being of our societies. Examples are strategies that slow functional decline and preserve personal capabilities in geriatric populations. Instrumental in developing these strategies is an in-depth knowledge of how older age affects the expression of chronic diseases through several mechanisms, such as age related comorbidity and cognitive/affective problems, decline/loss of social support, or atypical clinical presentations and special diagnostic problems. All this makes the elderly patient a complex client for the individual physician and for the healthcare system, and renders the traditional ''specialist'' approach poorly effective.