[Function-oriented prevention in geriatrics-No autonomy without structural change]

The goal of prevention in advanced age is less the avoidance of individual diagnoses and more the preservation of autonomy and functional capacity. Traditional categories, such as primary, secondary and tertiary prevention increasingly overlap as functional impairments and geriatric syndromes represent both risk factors and targets for intervention. Current care structures in Germany reveal a significant gap: isolated programs are insufficient to effectively prevent recurrent hospitalizations and the transition into long-term care dependency. Outpatient geriatric centers, connected to geriatric hospital departments, can serve as interdisciplinary hubs. Working in collaboration with primary care physicians, they enable early screening of relevant risks (e.g., sarcopenia, fall risk, polypharmacy), coordinate rehabilitative and preventive measures after hospital discharge and establish reliable entry points into preventive care, for example, through routine geriatric baseline assessments beginning at retirement age. The key elements are summarized in a table in the article, including cardiovascular prevention into advanced age, multifactorial fall prevention strategies incorporating nutrition and targeted exercise as well as differentiated deprescribing to minimize treatment-induced risks. Prevention in older adults can only be effectively implemented through structured outpatient services and professional case management.