Croatia Faces Aging Population Challenge, Needs Geriatric Medicine Overhaul

Croatia's population is aging at an accelerated rate, surpassing the European Union average and presenting significant challenges for its healthcare system. The median age of Croatian citizens is now 45.5 years, compared to the EU's average of 44.9 years. Furthermore, individuals over 65 constitute over 23% of the population, with the fastest-growing segment being those over 80, who are also the most medically complex and vulnerable patients.

The European Union recognizes population aging as a critical challenge for healthcare systems in the coming decades. It expects Southeast European countries, including Croatia, to adopt and standardize geriatric medicine according to the standards of more developed European nations. The Geriatric Section of the Croatian Medical Association is set to discuss the strategic development of geriatric medicine in Croatia in mid-June.

Professor Nenad Bogdanović, a neurogeriatrician at Sweden's Karolinska Institute, highlighted the distinction between gerontology, which studies aging, and geriatrics, which focuses on treating complex elderly patients. He explained that a geriatric patient is not merely an elderly individual but someone with multimorbidity, polypharmacy, functional decline, and cognitive impairment. Bogdanović stressed that chronological age does not equate to biological age, as individuals of the same age can have vastly different health statuses.

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Geriatric patient is not just an elderly patient. It is a person with multimorbidity, polypharmacy, functional decline and cognitive impairments. The key is to understand that chronological age is not the same as biological age; two patients of the same age can have completely different functionality and health status.

Bogdanović introduced the concept of "frailty," a state of increased vulnerability where minor stressors can lead to rapid deterioration, hospitalization, or permanent loss of function. Modern geriatrics requires a patient-centered approach that assesses functionality, cognition, nutrition, fall risk, and social context, moving beyond a disease-focused model. The goal is to preserve functionality, independence, and quality of life, not just treat illnesses.

To address these challenges, there is an expectation for countries like Croatia to develop standardized tools for early detection of frailty, sarcopenia, cognitive decline, and polypharmacy. The integration of healthcare and social services, along with the development of multidisciplinary teams, is crucial. This patient-oriented strategy aims to ensure that the elderly population receives comprehensive and effective care, adapting to their specific needs and vulnerabilities.

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The emphasis is on patient-centered care, not just on diseases. Development of standardized and validated tools for early detection of 'frailty', sarcopenia, cognitive disorders, polypharmacy and fall risk is particularly expected.