International cooperation can strengthen care forthe elderly

Elderly patients often live with several chronic conditions, experience declining physical functions and must take various kinds of medication. Treating each disease separately can leave important needs overlooked. International cooperation in geriatric medicine can help address this through better clinical assessment, medical training and coordination of care.

The Peking Union Medical College Hospital's Department of Geriatrics has maintained academic exchanges with Johns Hopkins University for two decades, having held 16 editions of their joint geriatrics forum. Such long-term interaction has enabled academic dialogue between Chinese and international scholars. Sustainable collaboration relies on joint research, youth training and standard-setting. Institutional frameworks reduce the risk of project disruption caused by personnel turnover. This model could also apply to academic exchanges between China and the United Kingdom, as well as between China and Europe.

Complexity is the central challenge in geriatric medicine. Multiple health conditions, polypharmacy, functional decline and psychosocial factors cannot all be addressed through a linear approach. Clinicians should focus on the main goal of the current hospitalization while assessing the combined effects of coexisting conditions. They should also screen people for geriatric syndromes and evaluate how interventions affect physical function and quality of life, incorporating patients' preferences into an individualized, comprehensive assessment.

Elderly people with multiple conditions and extensive medication use can be underrepresented in clinical trials. Geriatric medicine therefore requires clinicians, patients and families to weigh benefits and risks together and make informed, compassionate and individualized decisions.

Some leading US and European medical schools have adopted the geriatric "5Ms" framework, which encourages students to look beyond individual diseases and consider mind/mentation, mobility, medications, multicomplexity and what matters most to elderly patients. The framework has also informed clinical guidance, including recommendations from the American Heart Association on coronary revascularization in elderly adults and other recommendations from the elderly-adult section of the American Diabetes Association's Standards of Care.

These approaches offer useful lessons for medical education. Extending core geriatric principles and skills to clinicians across specialties could help improve care for elderly patients with complex needs.

Care systems need a similar shift. Treatment at a hospital is only one stage in an elderly person's healthcare. Chronic disease management, rehabilitation, long-term support and palliative care require continuity across institutions and settings. Geriatric departments can coordinate specialist input throughout admission, treatment, discharge and follow-up. Education for patients and caregivers should be part of this process, helping them understand and participate in ongoing care.

China's experience with elderly adults using smartphones to follow prescribed exercise programs and manage their health at home has drawn interest from international health experts. Based on this, our team has worked with clinical nutrition and rehabilitation specialists to develop X-Age, a digital system supporting assessment and management of sarcopenia, a condition involving loss of muscle strength and mass. The system connects assessment with nutrition, exercise interventions and follow-up. Implemented at 35 institutions across several Chinese regions, the system addresses certain clinical management challenges and offers a digital pathway for sarcopenia prevention and treatment.

International cooperation can also connect research on aging more closely with clinical practice. Studies of biological mechanisms should be linked to outcomes that matter in daily life, including physical function and independence. Shared research methods and interdisciplinary training can help clinicians and researchers assess whether new interventions produce meaningful benefits.

Taken together, these lessons point to the need for better clinical training, more consistent practice and coordinated care. Stronger collaboration across hospital departments and with overseas partners can help China put these lessons into practice while contributing its own experience to global efforts toward healthy aging.

The author is the chair of Geriatrics Division of Peking Union Medical College Hospital and a standing committee member of Geriatrics Branch of Chinese Medical Association. 

The author contributed this article to China Watch, a think tank powered by China Daily. The views do not necessarily reflect those of China Daily.

Contact the editor at editor@chinawatch.cn.