Understanding the multiple dimensions of ageing: 5Ms for the rheumatologist

Abstract

The global population is ageing and the rheumatology workforce should be prepared to take care of the inevitable complexities of ageing patients. We can learn from our colleagues and experts in geriatrics about how best to manage multimorbidity, polypharmacy, geriatric syndromes, and shifting priorities of older patients in the context of delivering care for rheumatic diseases. One approach to learning and adopting key ageing constructs within rheumatology practice is to incorporate the established Geriatric 5Ms-principles fundamental to caring for older adults. In this Series paper we discuss the 5Ms in the context of rheumatology practice (1) multicomplexity: assessing and managing multimorbidity and challenging biopsychosocial situations, (2) medications: ensuring that medications do not interfere with the other Ms, (3) mind: managing neurocognitive disorders and comorbid mental health conditions, (4) mobility: ensuring older adults can move independently and safely, and (5) what matters most: aligning care with an older adult's specific goals.

Figure 1:. Core components of each of the geriatric 5Ms and the interdisciplinary teams involved

Components of the Geriatric 5Ms and potential interdisciplinary team members who could be particularly appropriate to partner with for assessing and managing the specific M (in addition to the rheumatologist, the primary care provider, or geriatrician).

Figure 2:

Approaches and questions to help older adults communicate about what matters most