Precision Medicine: The Future Management of Geriatric Conditions

A general consensus about the need to manage geriatric conditions in their early phase has emerged following the disappointing results of several therapeutic trials, and as a consequence of accumulating research demonstrating that pathological processes begin years before the appearance of clinical symptoms. Several lessons have been learned from previous prevention trials. The targeted populations were too diverse, the interventions were probably not well-fitted and strong enough, and the time of exposure too short. In this paper, we focus on a new approach (Precision Medicine) that incorporates several components: 1. multi-pronged primary prevention at the population level (vascular and metabolic risk factors, physical activity, cognitive stimulation, and diet), 2. targeting persons at risk identified by specific criteria including biomarkers with the help of primary care health professionals (e.g., weight loss, subjective memory impairment, frailty, sarcopenia), 3. robust and specific interventions for the targeted population (e.g., a multi-domain interventions for a large heterogeneous population vs. interventions that target specific mechanisms of action in at risk populations). This new approach towards the therapy of geriatric conditions requires new concepts that integrate the specialist geriatric and primary care settings and that implements new health technologies. To achieve these goals, efforts must be made by healthcare authorities to maximize change in this field, taking into account the need to balance priorities, needs, and resources.