Urologial Diseases in a Aging Society: From Genetic to Medical Csre (UroAgeCare)

患者年龄大、体弱多病的特点是对压力的反应不恰当，这导致良性和恶性疾病的不良后果发生率更高。这最终导致临床情况，在这种情况下，对药物或手术治疗的反应可能导致更高的死亡率、住院率和致残率。与标准患者人群相比，关于这种疾病的遗传、表观遗传和免疫学背景的信息很少，而且仍然存在争议。值得注意的是，尽管泌尿外科的新手术和医疗干预措施不断发展，但临床试验的选择标准通常会导致低估或排除年龄较大或表现不佳的患者。考虑到西方国家的人口发展，随着老年患者数量的增加和合并症的增加，对年龄和虚弱的相关性进行更深入的分析是值得的。泌尿科是受老年人人口增长影响最大的医学专业，因为泌尿科问题在老年人中更为常见，而且护理65岁及以上的患者占泌尿科医生执业的很大比例。然而，到目前为止，泌尿外科还没有在研究水平上做出明确的努力，无论是实验还是转化，因此我们在临床护理老年患者时面临着巨大的知识缺陷。为今后更具体的泌尿系统疾病诊断和治疗方法奠定基础，更深入的多学科研究评估•与年龄和虚弱相关的泌尿系统疾病的自然史和生理学•分子生物学、免疫学、代谢和其他年龄相关因素对药物或手术治疗反应性的复杂改变的具体情况（即药物遗传学），•与并发疾病的相互作用及其对各自治疗的影响•在提供生活质量调整治疗信息方面，对老年和体弱患者进行评估和干预的健康-经济相关性。从遗传学到医学护理（UroAgeCare）是将来自不同医学领域的临床医生和研究人员的最新知识整合到一个跨专业的教师队伍中，在年龄和虚弱的特定主题下解决泌尿系统疾病和护理的各个方面。考虑到所描述的教师的高专业知识，一组选定的年轻研究人员将能够产生高质量的建议，为个别项目量身定制，同时打开超出泌尿学领域的额外影响。

High patient age and frailty are characterized by an inappropriate response to stress, that results in a higher frequency of adverse outcomes in benign and malignant disease. This ultimately leads to clinical scenarios where response to medical or surgical treatment may result in higher levels of mortality, institutionalization and disability. Information on the genetic, epigenetic and immunological background of this condition as compared to a standard patient population is scarce and still a matter of debate. Noteworthy, despite ongoing evolution of novel surgical and medical interventions in urology, selection criteria of clinical trials commonly result in an underestimation or exclusion of patients with high age or low performance status. Given the demographic development in Western countries, with increasing numbers of patients in advanced ages and with a growing number of comorbidities, a more profound analysis of the relevance of age and frailty is worthwhile. Urology represents the medical specialty that is most affected by the growing demographic of older adults as urological problems are by nature more common in elderly people, and care of patients aged 65 and older represents a large proportion of urologists’ practices. However, no explicit efforts on a research level, neither experimental nor translational, have been made till now in urology, so that we face a tremendeous deficite in our knowledge when taking care on elder patients in a clinical setting.To create a base for future more specific diagnostic and therapeutic approaches to urological conditions in this patient cohort, more in depth multidisciplinary research evaluating• the natural history and physiology of urological disease associated with age and frailty• specifics of the complex alterations in molecular biology, immunology, metabolism, and other age dependent factors contributing to responsiveness to medical or surgical treatment (i.e.pharmacogenetics, surgical outcome studies) • interaction with concurrent disease and their implications for the respective treatment• health-economic relevance of assessment and interventions in aged and frail patients under the aspect of providing information on quality-of-life-adjusted treatmentThe objective of the DFG-Nachwuchsakademie: Urological Diseases in an Ageing Society: From Genetics to Medical Care (UroAgeCare) is to integrate current cutting-edge knowledge from clinicians and researchers from diverse medical fields into an inter-professional faculty addressing all aspects of urological disease and care under the specific topic of age and frailty. Given the high expertise of the delineated faculty members, a selected group of young researchers will be able to generate high quality proposals, tailored for the individual project while opening additional reach beyond the field of urology.