Unlike Dick the Butcher

The Controversy

• How far can we extrapolate data for this population?
• To what extent can we base clinical practice on biologic plausibility in the absence of clinical trail data?

Over 50% of older adults have 3+ chronic conditions

• Over 50% of older adults have 3+ chronic conditions

• Increased risk of:

• Death
• Institutionalization
• Increased utilization of healthcare resources
• Decreased quality of life
• Higher rates of adverse effects of treatment or interventions

• Almost all existing “guidelines” have single disease focus

• Best approaches to decision-making and clinical management of older adults with multimorbidity remain unclear