Clinical reasoning and research in modern geriatrics often prioritises the disease concept. This is understandable as it has brought impressive advances in medicine (e.g. antibiotics, vaccines, successful cancer treatment and many effective surgeries). However, so far the disease framework has not succeeded in getting us to root causes of many age-related chronic diseases (e.g. Alzheimer’s disease, diabetes, osteoarthritis). Moreover, in aging and disease constructs alone fail to explain the variability in illness presentations. Therefore, we propose to apply the underused illness concept in a new way by reconsidering the importance of common symptoms in the form of a dynamic network of symptoms as a complementary framework. We show that concepts and methods of complex system thinking now enable to fruitfully monitor and analyse the multiple interactions between symptoms in such in networks, offering new routes for prognosis and treatment. Moreover, close attention to the symptoms that bother older persons may also improve weighing the therapeutic objectives of well-being and survival and aligning treatment targets with the patients’ priorities.

中文翻译：

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为什么疾病比老年疾病更重要

现代老年病学的临床推理和研究通常优先考虑疾病概念。这是可以理解的，因为它在医学上带来了令人印象深刻的进步（例如抗生素、疫苗、成功的癌症治疗和许多有效的手术）。然而，到目前为止，疾病框架还没有成功地让我们找到许多与年龄相关的慢性疾病（例如阿尔茨海默病、糖尿病、骨关节炎）的根本原因。此外，仅在衰老和疾病结构中无法解释疾病表现的可变性。因此，我们建议以一种新的方式应用未充分利用的疾病概念，重新考虑以动态症状网络形式作为补充框架的常见症状的重要性。我们表明，复杂系统思维的概念和方法现在能够有效地监测和分析网络中症状之间的多重相互作用，为预后和治疗提供新的途径。此外，密切关注困扰老年人的症状也可能有助于权衡健康和生存的治疗目标，并使治疗目标与患者的优先事项保持一致。