Contents


Preface

It is well known that the prevalence of chronic diseases is increasing rapidly worldwide, and approximately one-third of all adults globally suffer from more than one chronic condition. The prevalence rates of "multiple chronic conditions" (MCC), which indicates the presence of two or more chronic health conditions simultaneously in the same individual, are quite heterogeneous and show regional differences across the world. It is inevitable that MCC (also known as "multimorbidity") is becoming increasingly common as the world's population ages. As such, it is one of the greatest global health challenges associated with adverse individual, public, and financial outcomes, both now and in the future. *An Overview and Management of Multiple Chronic Conditions* is an up-to-date source of information for physicians, residents, and advanced medical students seeking a broader understanding of managing chronic disease clusters. The authors of the chapters come from many eminent centers around the world and are experts in

Considering MCC management in a broader context, the transition from a single disease-focused perspective to a patient-centered holistic approach may require considerable time and tremendous effort from health professionals and healthcare providers. Its burden to both the individual and society is increasing, probably due to lowered thresholds for diagnoses, advances in medical care, greater life expectancy, and possibly due to a true increase in the prevalence of some chronic diseases. Rheumatic and musculoskeletal diseases, which are among the most prevalent groups of non-communicable diseases, are highly variable medical conditions ranging from inflammatory rheumatic diseases and degenerative conditions to fragility conditions and regional pain syndromes. These diseases are the top three greatest contributors to years lived with disability in almost all world regions, as they are strong determinants of pain and disability limiting people's ability to manage their health. These diseases are also highly susceptible to MCC (especially in osteoporosis, osteoarthritis, and inflammatory arthritis) possibly due to their high incidence and low case fatality rate. They usually aggregate with a wide set of non-communicable diseases such as hypertension, cardiovascular diseases, dyslipidemia, diabetes, mental health problems, depression, and/or metabolic conditions. Recent studies also demonstrate that patients with chronic respiratory conditions, such as obstructive sleep apnea, chronic obstructive pulmonary disease, or idiopathic pulmonary fibrosis, commonly experience cognitive impairment as well. However, mild cognitive impairment is grossly underdiagnosed and undertreated by primary care physicians. Physicians who notice signs of memory loss, disorientation, gait impairment, or even poor adherence to pharmacologic/ nonpharmacologic treatment should screen their patients for cognitive dysfunction and refer them to a neurologist for a thorough evaluation. Physicians should also be aware of prevention strategies for cognitive dysfunction in chronic respiratory diseases. In addition, special caution should be taken with cognitive-related comorbidities with which these respiratory conditions are associated such as cerebrovascular diseases, cardiovascular pathology, and diabetes mellitus.

their respective fields.
