Abstract: In the context of global population aging, geriatric multimorbidity has become a major public health issue that threatens the health of older adults and escalates the healthcare burden. Scientifically and accurately quantifying the burden of geriatric multimorbidity is key to achieving precise diagnosis and treatment, prognostic prediction, and effective health management in this population. This paper systematically reviews the development trajectory of assessment tools for geriatric multimorbidity, categorizing them into a three-generation evolutionary framework, and summarizes the core characteristics, advantages, and limitations of each type of tool. Through a comparative analysis of current research status and shortcomings both domestically and internationally, it was found that existing tools suffer from inconsistent assessment standards, insufficient adaptation to local populations, a lack of research on disease-disease interactions, and inadequate clinical translation. Assessment tools for geriatric multimorbidity have progressively evolved from prediction-oriented to comprehensive assessment-oriented, and more recently toward localization and intelligent directions. Future development of these tools should be grounded in the disease spectrum of Chinese older adults, with emphasis on optimizing localized tools, addressing regional heterogeneity and dynamic trajectory tracking of multimorbidity, and developing a two-step strategy integrating universal rapid screening with pattern-specific assessment, while distinguishing core variables from extended variables to balance assessment depth and efficiency, thereby improving a multimorbidity assessment system tailored to national conditions and ultimately supporting healthy aging.

Key words: Geriatric multimorbidity, Multimorbidity assessment tools, Assessment system, Localization, Intelligent, Review

摘要： 在全球人口老龄化持续推进的背景下，老年共病已成为威胁老年人群健康、加重医疗负担的重要公共卫生问题。科学、精准地量化评估老年共病负担，是实现老年疾病精准诊疗、预后预测及健康管理的关键。本文系统梳理老年共病评估工具的发展脉络，将其划分为三代演进体系，总结各类工具的核心特征、优势与局限。通过对比分析国内外研究现状与现实短板，发现现有工具存在评估标准不统一、本土化适配不足、疾病交互作用研究欠缺、临床转化不充分等问题。老年共病评估工具已从预测型向综合评估型、本土化与智能化方向递进演进。未来需立足中国老年人群疾病谱，强化本土化工具优化，关注共病演变的区域异质性与动态轨迹追踪，构建普适性快速筛查与模式特异性评估相结合的两步策略，并区分核心变量与扩展变量以平衡评估深度与效率，完善适配国情的共病评估体系，为健康老龄化提供支撑。

关键词: 老年共病, 共病评估工具, 评估体系, 本土化, 智能化, 综述