Aging, Chronicity and Pulmonary Care Envejecimiento, cronicidad y atención neumológica

Over the last 60 years, we have witnessed a gradual change in the typical individual seeking healthcare. Our patient populations are now characterized by advancing age, increased incidence of chronic diseases, and a high prevalence of pluripathology. While it is true that chronic diseases can develop at any time during a patient’s lifetime, these 3 features are closely interrelated, so it is equally true that their prevalence increases with advancing age. The same occurs with the development of comorbidities. In the specific case of the lung, aging is associated with genomic instability and epigenetic changes that are key factors in the development of chronic lung diseases.1 According to the World Health Organization (WHO), chronic diseases account for over 60% of all deaths worldwide.2 Add to this the impact of these diseases on patient and caregivers’ quality of life, years of life lost,3 the economic burden and the costs of healthcare resources, and it is easy to understand how the care of chronic patients may be a major challenge for healthcare providers. The duty of these bodies is to achieve the best quality of care in chronicity, while continuing to offer the same level of care to acute cases. Improvements in social and healthcare standards mean that Spain is now among the countries with the longest life expectation worldwide, but the outcome of this is an increase in elderly subjects with chronic diseases. Chronic diseases currently account for 80% of consultations in primary care centers and 60% of hospital stays, particularly with respect to unscheduled admissions.4 It is estimated that by 2050, 35% of our population will be older than 75 years, so an exponential increase in the rate of chronic disease is only to be expected. The care of patients with chronic diseases, therefore, will be one of the most important challenges to be faced by the Spanish healthcare system in coming years. The WHO has called on governments to introduce measures based on 3 key elements: mapping chronic diseases and social, economic, behavioral and political factors; reducing exposure to risk factors; and reinforcing healthcare provisions.5 The implementation of specifically designed models for caring for populations with chronic diseases has been shown to be an efficient approach in