<p>In addition to the comorbidity load the functional status (extent of frailty) of old patients is the most important prognostic parameter and is decisive for the success of treatment. A&#xa0;regular initial assessment of the functional status should therefore be mandatory. Validated frailty scores are available for this purpose. Before the treatment the target of treatment should initially be determined and documented based on the comorbidity and functional status in dialogue with the patient and, if necessary, with the primary caregivers. An evaluation of which therapeutic procedure is deemed to be appropriate to reach the defined goal can only be made after this step. It must always first be examined how this objective can be achieved. It must also always be considered which treatment approach comes closest to the goal of maintaining the quality of life with the lowest possible risk of reduction of the quality of life. Depending on the treatment objective, this can include the complete unlimited surgical and interventional spectrum as well as limited interventions, e.g., for improvement of the arterial blood flow or also conservative palliative measures.</p>