There is a high correlation between the presence of multiple chronic co-morbid conditions, geriatric syndromes, iatrogenesis, and poor outcomes. Which comes first? Might the presence of geriatric syndromes be the clues to the diagnosis of underlying chronic illness? Or might the complex management of chronic co-morbid conditions lead to the development of geriatric syndromes? Give an example of each scenario and the implication for nurses.