Comorbidities complicate care

People in developed societies today are living longer than ever.  Generally, we are seeing most people living in good health until the age of 75, and even 80.  Yet at some point a person will develop comorbidities, and it's this that often makes the patient hard to treat.

This was the topic discussed by Helen M. Sorenson in the May 2012 issue of "AARC Times," in her article, "Common Comorbidities, Complications, and Consequences in the Elderly." 

Usually a person can make it through an entire life with one ailment.  As we know, there are many asthmatics, and many COPD, arthritis, osteoporosis and hypertension patients out there.

Yet when a person develops more than one disease, this is referred to as a comorbidity. In most cases, this occurs as a person ages, or as a disease progresses.  The following are common comorbidities listed by Sorenson:

1. Past heart attack
2. Hypertension
3. Congested Heart Failure
4. Atrial Fibrilation
5. Ventricular dysthrymias
6. Aortic or Mitral Valve Dysfunction
7. Diabetes
8. Renal Disease
9. Asthma
10. Urinary Tract Infection
11. Depression
12. Osteoporosis
13. Gastrointestinal Reflux (GERD)
14. Osteoarthritis

You can easily see how treating one may exacerbate or even cause the other.  If you're short of breath you'll probably require steroids, which can lead to diabetes.  Treatment for heart failure may lead to electrolyte imbalances that cause heart dysthrythmias.  Treatment for some dysthrythmias may trigger asthma.

So the patient, thus, becomes an enigma; a conundrum.  Sometimes we refer to these patients as a train wreck. 

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