Chronic disease in the elderly:a vital rationale for the revival of internal medicine

The phenomenon of population aging has led to a significant rise in the chronic disease rate compared to other human pathologies. Elderly people are usually affected by ≥2 chronic diseases concomittantly, mainly cardiovascular, pulmonary, and central nervous system diseases, metabolic disturbances and cancer. Chronic comorbidities in elderly patients may worsen their clinical status, making both the diagnosis and treatment more difficult. Meanwhile, contemporary medicine is focused on its subspecialties, thus turning away from the tradition of great, academic-based, general internal medicine. Clinical practice is dominated by a specific approach to a single disease rather than a patient with comorbidities. Therefore, an accurate diagnosis, ensuring effective treatment in the case of a complex and ambiguous clinical picture, is based on an attempt to combine multiple expert consultations rather than make a holistic evaluation, so characteristic of traditional internal medicine. For that reason, pathophysiology and clinical picture of a chronic disease in the elderly requires the revival of internal medicine, which is also essential to the development of geriatrics.