BACKGROUND & AIMS: INTRODUCTION:Diabetes mellitus is approaching epidemic proportions in most countries and has captured the attention of physicians at local, national and global levels. The elderly population remains at a higher risk for diabetes mellitus (1), and the disease poses unique concerns for geriatricians, primary care physicians, nurses and specialised pharmacists who provide care to the elderly. Glycaemic control, geriatric-related syndromes and cardiovascular risk factors considerably affect the elderly patient's functional status and life expectancy (2). Geriatric syndromes may include polypharmacy, chronic pain, injurious falls, cognitive impairment, urinary incontinence and depression. Higher rates of premature death; functional disability; and chronic illnesses, such as hypertension, cerebrovascular accidents, dementia and coronary artery disease, often affect elderly diabetic patients. DISCUSSION:Collaborative efforts are continually needed to allocate and maximise utilisation of resources to help empower older adults with diabetes to overcome barriers to disease management. Healthcare providers are increasingly challenged by the complexity of problems that face old patients, and must therefore be prepared to assess and treat diabetes mellitus within the milieu of many geriatric-related chronic illnesses. Healthcare providers must tailor individualised treatment methods, with the ultimate goal of not only achieving laboratory norms but also improving the quality of life for this vulnerable population. CONCLUSION:There is a need for extra care and overcoming barriers to diabetes control in old patients as a dynamic and a continuous task that needs coordination of healthcare systems and professionals at all levels of care.

背景与目标： 简介：在大多数国家，糖尿病已接近流行病的程度，并引起了地方，国家和全球各级医生的关注。老年人口患糖尿病的风险较高（1），该疾病引起了为老年人提供护理的老年医生，初级保健医生，护士和专业药剂师的独特关注。血糖控制，老年性综合症和心血管危险因素会严重影响老年患者的功能状态和预期寿命（2）。老年综合症可能包括综合制药，慢性疼痛，跌倒，认知障碍，尿失禁和抑郁症。较高的过早死亡率；功能障碍；慢性疾病，例如高血压，脑血管意外，痴呆和冠状动脉疾病，通常会影响老年糖尿病患者。
讨论：持续需要协作努力来分配和最大程度地利用资源，以帮助增强糖尿病的成年人克服疾病管理的障碍。老年患者面临的问题的复杂性日益使医疗保健提供者面临挑战，因此，医疗保健提供者必须做好准备以评估和治疗许多与老年病有关的慢性病范围内的糖尿病。医疗保健提供者必须量身定制个性化的治疗方法，其最终目标不仅要达到实验室规范，而且要改善这一弱势群体的生活质量。
结论：作为一项动态且持续的任务，需要对老年患者进行额外的护理和克服糖尿病控制障碍，这需要医疗保健系统和各个护理级别的专业人员进行协调。

BACKGROUND & AIMS: OBJECTIVE:To describe the development, implementation, and assessment of a geriatric pharmacotherapy elective course emphasizing a patient-centered approach and active, self-directed learning strategies. DESIGN:The course content included fundamental concepts in aging, geriatric syndromes, activities involving assessment of medically complex older adults, presentation of controversies in clinical geriatrics, book and film clubs, an Adopt-a-Patient project, and scientific and reflective writing. Students participated in site visits to interview and interact with older adults. ASSESSMENT:Student evaluation of the course was assessed with the teaching evaluation tool, an end-of-semester survey, a follow-up P4 survey, and reflective writings. Students strongly agreed that course goals were achieved. Learning how to communicate with older adults and assess complex medication regimens were the areas of highest importance to students. P4 students strongly agreed that skills learned in the course were important to their success in advanced pharmacy practice experiences (APPEs). CONCLUSION:A pharmacotherapy course emphasizing active and self-directed learning in geriatrics through innovative teaching was adaptable to doctor of pharmacy (PharmD) students at various stages of their training and improved students' perceptions of aging.

背景与目标： 目的：描述老年药物疗法选修课程的开发，实施和评估，该课程强调以患者为中心的方法和主动的，自我指导的学习策略。
设计：课程内容包括衰老，老年综合症，涉及评估医学上复杂的成年人的活动，临床老年病争议，书籍和电影俱乐部，收养患者项目以及科学和反思性写作等基本概念。学生参加了现场访问，以采访老年人并与之互动。
评估：使用教学评估工具，学期末调查，后续P4调查和反思性写作对课程的学生评估进行了评估。学生们强烈同意达到课程目标。学习如何与老年人沟通并评估复杂的药物治疗方案对学生而言是最重要的领域。 P4学生强烈同意，该课程中学习的技能对于他们在高级药学实践经验（APPE）中的成功至关重要。
结论：通过创新教学强调老年医学中主动和自主学习的药物疗法课程适合药学（PharmD）学生在其培训的各个阶段，并改善了学生对衰老的认识。

BACKGROUND & AIMS: OBJECTIVE:The objectives of this work were to determine the prevalence of self-reported subclinical status for functional limitation and disability at baseline and assess their independent effects on the onset of functional limitation and disability 1-2 years later. METHODS:Nine hundred ninety-eight African American men and women 49-65 years old in St. Louis, MO, received comprehensive in-home evaluations at baseline and two annual telephone follow-ups. Outcome measures included walking a half-mile, climbing steps, stooping-crouching-kneeling, lifting or carrying 10 lbs., and doing heavy housework. RESULT:The baseline prevalence of subclinical status was 26.4% for walking a half-mile, 26.8% for climbing steps, 39.0% for stooping-crouching-kneeling, 29.1% for lifting or carrying 10 lbs., and 22.7% for doing heavy housework. The adjusted odds ratios for the task-specific subclinical status measure at baseline on developing difficulty 1-2 years later were 1.68 (p < .05) for walking a half-mile, 4.46 (p < .001) for climbing steps, 2.48 (p < .001) for stooping-crouching-kneeling, 2.51 (p < .001) for lifting or carrying 10 lbs., and 2.22 (p < .001) for doing heavy housework. Performance tests (tandem stand, chair stands, and preferred gait speed) did not have consistent independent effects on the onset of functional limitation or disability. CONCLUSION:The subclinical status measures were the main predictors of the onset of difficulty in all tasks and functions 1-2 years later. Interventions to reduce frailty should focus on self-reported subclinical status as an early warning system.

背景与目标： 目的：这项工作的目的是确定基线时自我报告的功能受限和残障亚临床状态的普遍性，并评估其在1-2年后对功能受限和残障发作的独立影响。
方法：密苏里州圣路易斯的988名49-65岁的非洲裔美国人，在基线时接受了全面的室内评估，并接受了两次年度电话随访。结果措施包括步行半英里，爬上台阶，弯腰蹲下跪，举起或抬起10磅体重以及做繁重的家务劳动。
结果：亚临床状态的基线患病率是半英里步行26.4％，爬山台阶26.8％，弯腰屈膝跪姿39.0％，举重或举重10磅29.1％，繁重的家务劳动22.7％ 。在1-2年后因发展困难而在基线时针对特定任务的亚临床状态测量值的调整后优势比为：半英里步行时为1.68（p <.05），攀登步骤为4.46（p <.001），为2.48（p跪着蹲下时p <.001），举起或搬运10磅重时为2.51（p <.001），而做繁重的家务则为2.22（p <.001）。性能测试（纵排站立，椅子站立和优选的步态速度）对功能受限或残疾的发作没有一致的独立影响。
结论：亚临床状态测量是1-2年后所有任务和功能出现困难的主要预测指标。减少体弱的干预措施应着重于自我报告的亚临床状态，作为预警系统。

BACKGROUND & AIMS: :Clinically significant non-major depression has been underinvestigated, despite its high prevalence and public health impact. Although there is increasing recognition of the importance of subsyndromal forms of depression, their nosologic boundaries and neurobiologic mechanisms remain largely unknown. This review discusses the literature pertaining to the current concepts, phenomenology, neurobiology, and treatment approaches for geriatric non-major clinically significant depression. The authors examine the similarities and differences between various subtypes of depressive disorders, and compare non-major clinically significant depression in the elderly with non-geriatric adult populations. The authors draw conclusions from the published literature and present clinical criteria for the diagnosis of clinically significant non-major depression in the elderly.

背景与目标： ：尽管临床流行率很高且对公共卫生有影响，但尚未对临床上显着的非重大抑郁症进行调查。尽管人们越来越认识到亚综合征形式的抑郁症的重要性，但它们的病理学界限和神经生物学机制仍是未知之数。这篇综述讨论了有关老年非重大临床意义抑郁症的最新概念，现象学，神经生物学和治疗方法的文献。作者检查了各种抑郁症亚型之间的异同，并比较了非老年成人人群中非重大临床意义的抑郁症。作者从已发表的文献中得出结论，并提出了诊断老年人临床上重要的非重大抑郁症的临床标准。

BACKGROUND & AIMS: :In the recent past, most physician visits by older adults were with a primary care physician, with less than 40% of ambulatory visits to other specialists. Since 1991, that trend has reversed. In 2001, 53% of ambulatory visits by patients aged 65 years or older were to nonprimary care specialists. Demographic trends and an expanding geriatrics medicine knowledge base require that every physician develop skills specific to the care of older adults. There are concerns that physicians-in-training are not learning adequate specific geriatrics medicine content to prepare them for the rapidly expanding numbers of older adults who will be seeking medical care. Training standards to prepare residents and fellows for practicing medicine are established by experts in the various medical specialties serving on individual residency review committees (RRCs) of the Accreditation Council for Graduate Medical Education. In 2002 (with a follow-up in 2003), the Association of Directors of Geriatric Academic Programs' team at the University of Cincinnati School of Medicine's Institute for Health Policy and Health Services Research reviewed all 91 nonpediatric specialties' RRC program requirements to identify the specific curriculum requirements related to geriatrics medicine training. As of 2003, 27 of the 91 RRC-accredited specialties have specific geriatrics training requirements; the other 70% of these specialties did not specifically mention geriatrics training. Even among the specialties with specific geriatrics training requirements, curriculum expectations are modest. The geriatrics-specific descriptions within the program requirements of the 27 specialties are presented in this article. The authors encourage the RRCs for all nonpediatric specialties to update their program requirements to ensure that future physicians graduating from their graduate medical education programs are adequately prepared to care for older adults.

背景与目标： ：最近，大多数老年人的医师就诊都是由初级保健医师进行的，不到40％的其他专科就诊者就诊。自1991年以来，这种趋势已经逆转。在2001年，年龄在65岁或65岁以上的患者的非卧床就诊中有53％是非初级保健专家进行的。人口趋势和不断扩展的老年医学知识基础要求每位医师都应发展专门针对老年人的护理技能。令人担忧的是，接受培训的医生没有学习到足够的特定老年医学药物含量，无法为将要寻求医疗服务的迅速增长的老年人做准备。由研究生医学教育认可委员会的个人住院医师审查委员会（RRC）中服务的各个医学专业的专家制定了为居民和医学从业人员做准备的培训标准。 2002年（2003年进行了跟进），辛辛那提大学医学院健康政策与健康服务研究所的老年医学项目主管小组审查了所有91个非儿科专业的RRC计划要求，以确定与老年医学培训有关的具体课程要求。截至2003年，在91个获得RRC认可的专业中，有27个具有特定的老年医学培训要求。这些专业中的其他70％没有专门提及老年医学培训。即使在具有特定老年医学培训要求的专业中，对课程的期望也很低。本文介绍了27个专业的计划要求内的老年医学特定描述。作者鼓励所有非儿科专业的RRC更新其计划要求，以确保从其研究生医学教育计划毕业的未来医生有足够的准备来照顾老年人。

BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: OBJECTIVES:The European Working Group on Sarcopenia in Older People 2 (EWGSOP2) recently defined the new concept of probable sarcopenia to help improve screening and prevent future sarcopenia. We investigated the prevalence of probable sarcopenia, defined as weak grip strength, in community-dwelling older Colombian adults, and examined the long-term associated conditions. DESIGN:Cross-sectional study. SETTING:Urban and rural Colombian older adults from the "Estudio Nacional de Salud, Bienestar y Envejecimiento (SABE) study". PARTICIPANTS:5237 Colombian older adults aged ≥60 years. MEASUREMENTS:Probable sarcopenia was assessed following the cut-off points for weak grip strength recommended by EWGSOP2 guidelines. Odds ratios (ORs) of the relationship between long-term conditions and probable sarcopenia were determined using logistic regression. RESULTS:The prevalence of probable sarcopenia defined as weak grip strength was 46.5% [95% confidence interval (CI), 45.1-47.8]. Physical inactivity "proxy" (OR 1.35, 95% CI 1.14-1.59); diabetes (OR 1.32, 95% CI 1.11-1.56); and arthritis, osteoarthritis, and rheumatism (OR 1.44, 95% CI 1.25-1.67) were independently associated with probable sarcopenia. CONCLUSIONS AND IMPLICATIONS:We found that almost half of all the Colombian older adults in our sample had probable sarcopenia. Individuals with physical inactivity, diabetes, arthritis, or osteoarthritis and rheumatism had a higher prevalence of probable sarcopenia. Probable sarcopenia is clinically highly relevant, and several of the factors associated with this condition are potentially preventable, treatable, and reversible.

背景与目标： 目的：欧洲老年人肌肉减少症工作组2（EWGSOP2）最近定义了可能的肌肉减少症的新概念，以帮助改善筛查和预防未来的肌肉减少症。我们调查了居住在社区中的哥伦比亚老年人中可能的肌肉减少症的患病率（定义为较弱的握力），并研究了长期相关的状况。
设计：横断面研究。
地点：来自“ Estudio Nacional de Salud，Bienestar y Envejecimiento（SABE）研究”的城市和哥伦比亚农村老年人。
参加人数：5237名年龄≥60岁的哥伦比亚老年人。
测量：根据EWGSOP2指南推荐的弱握力临界值，评估可能的肌肉减少症。使用logistic回归确定长期病情与可能的少肌症之间关系的几率（OR）。
结果：可能的肌肉减少症的患病率定义为较弱的握力，为46.5％[95％置信区间（CI），45.1-47.8]。缺乏体育活动的“代理人”（OR 1.35，95％CI 1.14-1.59）；糖尿病（OR 1.32，95％CI 1.11-1.56）;关节炎，骨关节炎和风湿病（OR 1.44，95％CI 1.25-1.67）分别与可能的肌肉减少症相关。
结论和意义：我们发现样本中几乎一半的哥伦比亚老年人都患有肌肉减少症。缺乏运动，糖尿病，关节炎或骨关节炎和风湿病的人患肌肉减少症的可能性较高。可能的肌肉减少症在临床上具有高度相关性，与这种情况相关的一些因素是潜在可预防，可治疗和可逆的。

BACKGROUND & AIMS: :Nursing homes typically have been a relatively isolated component of health care in the United States. Now, however, nursing homes are experiencing a change in the patients they serve. In recent years, nursing home patients have been admitted sicker and after a shorter hospital stay than in the past. Such changes are likely to continue to occur as the size of the population of frail elderly continues to increase and as insurers look for alternatives to high cost hospital care. An additional stimulus to change is that the public is asking for innovation in noninstitutionalized long-term care. This essay advocates that nursing homes are the ideal component of the health care system to lead innovative program development focused on the creation of a highly organized continuum of care for the frail elderly. Physicians must be a fundamental part of this process, providing the guidance and leadership necessary for nursing homes to evolve into comprehensive geriatrics centers. Strategies are provided for developing physician office practices in nursing homes, a fundamental first step in the process of change. Additionally, ideas are provided for developing day care centers and physician house call programs based in nursing homes. Also, tight and highly functional relationships among nursing homes and acute hospitals must be developed. The example of the Johns Hopkins Geriatrics Center is described briefly as one such program now in place.(ABSTRACT TRUNCATED AT 250 WORDS)

背景与目标： ：在美国，疗养院通常是相对孤立的医疗保健组成部分。但是，现在，疗养院的服务患者正在发生变化。近年来，与过去相比，疗养院患者的病情和住院时间短。随着脆弱的老年人口数量的不断增加以及保险公司寻求替代高成本医院护理的机会，这种变化很可能会继续发生。改变的另一个刺激因素是，公众要求在非机构化的长期护理中进行创新。本文主张，养老院是医疗保健系统的理想组成部分，可以引领创新计划的发展，重点是为脆弱的老年人提供高度组织化的连续护理。医师必须是该过程的基本组成部分，为疗养院发展成为综合的老年医学中心提供必要的指导和领导。提供了在疗养院中发展医师办公室实践的策略，这是变革过程中的基本第一步。此外，还为在养老院中建立日托中心和医师上门服务计划提供了思路。此外，必须在疗养院和急诊医院之间建立紧密和高度有效的关系。约翰霍普金斯老年医学中心的示例已被简要描述为一个这样的程序。（摘要以250字截断）

BACKGROUND & AIMS: :Department of Veterans Affairs (VA) Geriatric Research, Education and Clinical Centers (GRECCs) originated in 1975 in response to the rapidly aging veteran population. Since its inception, the GRECC program has made major contributions to the advancement of aging research, geriatric training, and clinical care within and outside the VA. GRECCs were created to conduct translational research to enhance the clinical care of future aging generations. GRECC training programs also provide leadership in educating healthcare providers about the special needs of older persons. GRECC programs are also instrumental in establishing robust clinical geriatric and aging research programs at their affiliated university schools of medicine. This report identifies how the GRECC program has successfully adapted to changes that have occurred in VA since 1994, when the program's influence on U.S. geriatrics was last reported, focusing on its effect on advancing clinical geriatrics in the last 10 years. This evidence supports the conclusion that, after more than 30 years, the GRECC program remains a vibrant "jewel in the crown of the VA" and is poised to make contributions to aging research and clinical geriatrics well into the future.

背景与目标： ：退伍军人事务部（VA）老年医学研究，教育和临床中心（GRECC）始建于1975年，以应对迅速老龄化的老龄人口。自成立以来，GRECC计划为VA内外的衰老研究，老年医学培训和临床护理的发展做出了重要贡献。 GRECCs的创建是为了进行转化研究，以增强对未来衰老世代的临床护理。 GRECC培训计划还在培训医疗保健提供者有关老年人的特殊需求方面发挥了领导作用。 GRECC计划还有助于在其附属大学医学院建立强大的临床老年和衰老研究计划。该报告确定了GRECC计划如何成功地适应了自1994年以来VA发生的变化，当时该计划对美国老年病的影响是最近一次报告的，重点是它在最近10年中对推进临床老年病的影响。该证据支持以下结论：三十多年来，GRECC计划仍然是充满活力的“弗吉尼亚州皇冠上的宝石”，并有望在未来为衰老研究和临床老年医学做出贡献。

BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: :Although the fields of hospice and palliative medicine and geriatrics have developed from separate origins, they share much in common. They share concerns for optimizing care of older adults with advanced illness. They both seek to address the common problem of care fragmentation for those with chronic illness. Both subspecialties see the patient and their loved ones as a unit requiring thoughtful, integrated care, rather than seeing the patient as a cluster of organ systems and conditions. The fields also share many core principles, including an emphasis on interdisciplinary care and care coordination. As increasing emphasis is placed on the medical home, chronic and advanced illness care, and systems changes to decrease care fragmentation, geriatrics and hospice and palliative medicine stand to benefit by blending efforts and common interests to improve care for patients and their loved ones. In 2009, a collaborative effort was begun involving the leadership of the American Geriatrics Society, the American Academy of Hospice and Palliative Medicine, and the John A. Hartford Foundation. The goal of the collaboration was to convene leaders in geriatrics and hospice and palliative medicine to identify areas of potential synergy between the two subspecialties and to design a plan for exploring and developing these areas of common interest. This article describes the progress of the collaborative effort to date.

背景与目标： ：尽管临终关怀，姑息医学和老年医学领域是从不同的起源发展而来，但它们有很多共同点。他们共同关心优化患有晚期疾病的老年人的护理。他们都试图解决慢性病患者护理分散的普遍问题。这两个子专业都将患者及其亲人视为需要周到的综合护理的单元，而不是将患者视为器官系统和条件的综合体。这些领域还共享许多核心原则，包括强调跨学科护理和护理协调。随着人们越来越重视医疗家庭，慢性病和高级疾病护理，以及为了减少护理分散而进行的系统变革，老年医学，临终关怀和姑息医学将通过努力与共同利益相结合而受益，以改善对患者及其亲人的护理。在2009年，美国老年医学学会，美国临终关怀和姑息医学研究院以及约翰·哈特福德基金会的领导者开始了合作努力。合作的目的是召集老年病，临终关怀和姑息医学领域的领导人，以查明两个亚专业之间潜在的协同作用领域，并制定计划来探索和发展这些共同感兴趣的领域。本文介绍了迄今为止的协作成果。

BACKGROUND & AIMS: OBJECTIVE:(i) To assess quality of life (QoL) profiles in hypertensive geriatrics with SF-36; (ii) to assess the compliance of geriatrics to medications; (iii) to estimate clinical outcomes (reduction in systolic and diastolic blood pressure); (iv) to assess life satisfaction and (v) to explore the interrelationships of QoL, compliance, clinical outcomes and life satisfaction in hypertensive geriatrics. METHOD:Fifty-nine hypertensive geriatric patients in cardiology and 65 Plus clinics in West Virginia Hospitals were studied. RESULTS:Age showed a significant negative correlation with physical functioning (r = 0.339, P< or =0.0127) and physical role (r=0.335, P< or =0.0148). The physical role facet of SF-36 is correlated with life satisfaction in geriatrics (r = 0.316, P < or =0.0219). A regression analysis (backward stepwise) not including bodily pain (BP) and general health (GH) resulted in a model explaining 22.3% of variance (n = 54, F = 2.252, P < or = 0.0543). Physical role (P < or = 0.0084) and mental health facets (P< or = 0.0184) of SF-36 emerged as the predictors of life satisfaction in elderly hypertensive patients. Emotional role functioning (P < or = 0.0257) and social functioning (P < or = 0.0033) scores predicted levels of diastolic blood pressure in elderly hypertensive patients. However, all eight concepts of SF-36 failed to predict compliance behaviour in geriatrics (n = 53, P < or = 0.6913, R2= 0.110).

背景与目标： 目的：（i）用SF-36评估高血压老年患者的生活质量（QoL）； （ii）评估老年医学对药物的依从性； （iii）评估临床结局（收缩压和舒张压的降低）； （iv）评估生活满意度，以及（v）探索高血压老年患者的生活质量，依从性，临床结果和生活满意度之间的相互关系。
方法：对西弗吉尼亚医院的59例心脏病患者和65多家诊所进行了研究。
结果：年龄与身体机能（r = 0.339，P <或= 0.0127）和身体角色（r = 0.335，P <或= 0.0148）呈显着负相关。 SF-36的生理角色与老年人的生活满意度相关（r = 0.316，P <或= 0.0219）。不包括身体疼痛（BP）和总体健康（GH）的回归分析（向后逐步）产生了一个解释22.3％方差的模型（n = 54，F = 2.252，P <或= 0.0543）。 SF-36的生理作用（P <或= 0.0084）和心理健康方面（P <或= 0.0184）已成为老年高血压患者生活满意度的预测指标。情绪角色功能（P <或= 0.0257）和社会功能（P <或= 0.0033）得分可预测老年高血压患者的舒张压水平。但是，SF-36的所有八个概念均无法预测老年病患者的依从性行为（n = 53，P <或= 0.6913，R2 = 0.110）。

BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: :The population in the United States is aging and presents many challenges in the healthcare world. According to the report released by United States Census Bureau in June 2017, there are around 50 million residents aged 65 years and over as of 2016. Among the multiple healthcare challenges, kidney disease is a significant one because of its high burden, high cost and low awareness. Medicare spending on chronic kidney disease for 65 plus aged patients exceeded $ 50 billion in 2013. Different studies based on different calculations have estimated that at least one-third of chronic kidney disease patients are aged above 65 years. Most of the chronic kidney disease patients have multiple medical co-morbidities but geriatric syndromes are added factors that may be challenging for nephrologists. There is scarcity of well-trained geriatricians and in most instances, nephrologists take over the role of internist or geriatrician. This article outlines the need and importance of collaboration and coordination between geriatrics and nephrology for the best patient care and better healthcare outcomes.

背景与目标： ：美国人口正在老龄化，并在医疗保健领域提出了许多挑战。根据美国人口普查局2017年6月发布的报告，截至2016年，约有5000万65岁及以上的居民。在多种医疗保健挑战中，肾脏疾病是一个重大挑战，因为其负担重，成本高且意识低下。 2013年，用于65岁以上老年患者的慢性肾脏病医疗保险支出超过500亿美元。基于不同计算的不同研究估计，至少三分之一的慢性肾脏病患者年龄在65岁以上。大多数慢性肾脏病患者有多种医学上的合并症，但老年综合症是增加因素，可能会给肾病医师带来挑战。缺乏训练有素的老年医生，在大多数情况下，肾病医生接替内科医生或老年医生的角色。本文概述了老年病学和肾脏病学之间进行协作与协调以获得最佳患者护理和更好的医疗保健结果的必要性和重要性。

BACKGROUND & AIMS: :After having occupied a modest place in the Danish health system for many years, geriatrics now shows signs of stability and growth. Instruction in geriatrics has been strengthened by the creation of a professorship in 1991. Structural changes, particularly in the Copenhagen hospital system since 1987, have given geriatrics a more prominent place, and from 1992, there will be more emphasis on this field. There has been increased interest in geriatrics in the primary health care sector on the part of general practitioners and home nurses. Geriatrics in the hospital sector takes the form of separate departments in large acute hospitals and independent hospital units and elsewhere is seen as a part of departments of internal medicine. In Denmark, the geriatric patient is a patient with many concomitant physical and psychic illnesses and the resultant social problems. Acute organ specific problems are generally taken care of outside of geriatric departments.

背景与目标： ：老年医学在丹麦卫生系统中占据了很低的位置之后，现在显示出稳定和增长的迹象。 1991年设立了教授职位，从而加强了老年病学的教学。结构的变化，尤其是1987年以来在哥本哈根医院系统中的变化，使老年病学的地位更加突出，从1992年开始，该领域将更加受到重视。全科医生和家庭护士对初级保健部门中的老年医学越来越感兴趣。医院部门的老年病采取大型急诊医院和独立医院单位中独立部门的形式，其他地方被视为内科部门的一部分。在丹麦，老年患者是患有许多伴随的身体和精神疾病以及随之而来的社会问题的患者。急性器官特有的问题通常在老年科之外进行。