Including prognosis evaluation in the management of older patients across different healthcare settings: The Cologne Experience

The increase of the older population hypothesized during the last century for the beginning of the third millennium was fundamental for the establishment and development of the medical discipline of geriatrics as well as of biogerontological research. This increase, however, is reaching unexpected proportions, due to various scenarios demographic investigations could not predict. These include among others accelerated vs. usual aging and initial amelioration of quality of life in the recent generations vs. subsequent worsening of disability prevalence. The major consequence for this situation is that healthcare systems are challenged in keeping the pace with the individual and social demands of the older population. This situation requires an urgent paradigm shift with the implementation of authentic comanagement of medical specialists and geriatricians for the amelioration of integrated and transitional care. The present work shows the first results of the studies from a task force established 2015 at the Dpt. II of the University Hospital of Cologne with the aim of integrating personalized medicine with high-performance organ medicine in older adults accessing various non-geriatric medical settings.