Multimorbidity in the elderly: Are we prepared for it!

35 Globally, more so in developing countries, the elderly population is rising. The increasing elderly population is posing its own challenges. One of the major challenges is multimorbidity. Multimorbidity is defined as “existence of multiple medical conditions in a single individual.”[1] Others have tried to define multimorbidity as an accumulation of two or more chronic diseases, whereas others have considered it to be the accumulation of three or more diseases.[2,3] In terms of chronicity, various diseases which have been included in the definition of multimorbidity include those which are considered to have permanence, are associated with disability, are associated with irreversible pathological changes in the body’s system, require long‐term supervision, observation, and care and are associated with special training needs for the patient’s rehabilitation.[2] Other authors have used the term long‐term conditions instead of chronic and defined the long‐term conditions like those, which cannot be cured but can be controlled by the use of medications or other treatments.[4] It is suggested that compared to those without multimorbidity, those with multimorbidity have a higher chance of functional decline, poorer quality of life, and more often use of health‐care services.[4] Some of the authors also suggest that there is a significant overlap between multimorbidity and frailty.[4] There are also some data to suggest that multimorbidity is associated with increased mortality.[5] Accordingly, those with multimorbidity are considered to be patients with complex healthcare needs, who have significantly higher healthcare needs, and pose a significant burden on the available health‐care services.[6]