Author Affiliation: Department of Neurology, Beth Israel Deaconess Medical Center, Boston, Mass.
Clinicians are always hoping to identify a single unifying diagnosis,
but, in fact, many patients have more than one medical problem. Individuals
seem to accumulate diseases (and different drug prescriptions) as they age.
Physicians who care for elderly patients are well aware that multiple coexisting
diagnoses are the rule rather than the exception.
Some risk factors predispose to multiple different pathogens and pathological
processes and identifying them depends on the thoroughness and duration of
the search. Genetic composition, lifestyle factors, and multiple exposures
to potential pathogenetic elements over time help explain the coexistence
of multiple different and often unrelated medical problems. Few problem-oriented
lists in patients older than 70 years are short; probably none include single
Caplan LR. Multiple Potential Risks for Stroke. JAMA. 2000;283(11):1479–1480. doi:10.1001/jama.283.11.1479