[Comprehensive assessment of comorbidity in the elderly]

The ageing is accompanied by a progressive decline in physical activity, a social vulnerability and an increase in the prevalence of the chronic diseases. The comorbidity brings a description which modifies the repercussion of the usual processes of the ageing in term of vital and functional prognosis. The comorbidities must be integrated into the comprehensive geriatric assessment as well as the other aspects like cognition or the nutrition. The tools for global evaluation of the comorbidity bring information on their presence and on the load which they will impose on the medical decisions because they are predictive tolerance and benefit. The comorbidities can also be described in the context of a pathology like the oncology for example. The comorbidities could be the cause of delay diagnosis, will influence the evolution and the therapeutic tolerance and will give information about the forecast. It will then be necessary to use scales of comorbidities adapted to the speciality while avoiding having a scale by pathology what would reduce feasibility without increasing its utility. The comorbidities were often forgotten in comprehensive geriatric assessment pratice and should be studied in order to adapt the therapeutic decisions in an approach of personalised medicine.