Prognostic and Therapeutic Implications of Frailty in Older Adults with Heart Failure

Current Cardiology Reports
Michael GoldfarbJonathan Afilalo

Abstract

Frailty is increasingly recognized in older adults with cardiovascular disease, particularly in those with heart failure (HF). A growing body of evidence has shown that frailty has a negative effect on survival, hospitalizations, disability, and quality of life. Beyond frailty, additional domains captured by a comprehensive geriatric assessment contribute incremental value in predicting outcomes and identifying treatment targets. Exercise training is ideally suited to this setting as it can concomitantly improve physical frailty and HF symptoms. Multidisciplinary disease management programs offer a number of benefits for frail HF patients; invasive procedures carry a higher risk of morbidity than in non-frail counterparts, and evidence-based drugs and devices have an uncertain value and warrant further research. While more data accrues, difficult therapeutic decisions should be individualized using a shared patient-centered decision making approach.

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Citations

Apr 4, 2016·Revista española de geriatría y gerontología·Francesc Formiga, Albert Ariza-Solé
Jun 8, 2018·Transplantation·Lior BibasJonathan Afilalo
Feb 17, 2018·Research in Gerontological Nursing·Youn-Jung Son, Eun Ji Seo
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Dec 31, 2019·European Heart Journal Supplements : Journal of the European Society of Cardiology·Cristiana Vitale, Izabella Uchmanowicz
Jun 1, 2016·JACC. Clinical Electrophysiology·Lior BibasJonathan Afilalo

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