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2016 ; 32
(9
): 1140-7
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Heart Failure in Older Adults
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Butrous H
; Hummel SL
Can J Cardiol
2016[Sep]; 32
(9
): 1140-7
PMID27476982
show ga
Heart failure (HF) is a leading cause of morbidity, hospitalization, and
mortality in older adults and a growing public health problem placing a huge
financial burden on the health care system. Many challenges exist in the
assessment and management of HF in geriatric patients, who often have coexisting
multimorbidity, polypharmacy, cognitive impairment, and frailty. These complex
"geriatric domains" greatly affect physical and functional status as well as
long-term clinical outcomes. Geriatric patients have been under-represented in
major HF clinical trials. Nonetheless, available data suggest that
guideline-based medical and device therapies improve morbidity and mortality.
Nonpharmacologic strategies, such as exercise training and dietary interventions,
are an active area of research. Targeted geriatric evaluation, including
functional and cognitive assessment, can improve risk stratification and guide
management in older patients with HF. Clinical trials that enroll older patients
with multiple morbidities and HF and evaluate functional status and quality of
life in addition to mortality and cardiovascular morbidity should be encouraged
to guide management of this age group.
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