Geriatric conditions in heart failure

Abstract

As the U.S. population ages, the prevalence of geriatric conditions in patients with heart failure is increasing, although they currently fall outside the traditional heart failure disease model. In this review, we describe the co-occurrence of four common geriatric conditions (cognitive impairment, frailty, falls, and incontinence) in older adults with heart failure, their mechanisms of interaction, and their association with outcomes. We propose a new paradigm to meet the needs of the aging heart failure population that includes comprehensive assessment of geriatric conditions and tailoring of therapy and surveillance accordingly. Coordination among relevant disciplines such as cardiology and geriatrics may facilitate this transition. Further research is needed in order to understand how to optimize care for patients with specific impairments in order to improve outcomes.

Conflict of interest statement

Disclosure: No potential conflicts of interest relevant to this article were reported.

Figures

Figure 1

Theoretical relationship between geriatric conditions and outcomes in heart failure. In this model, which is simplified for illustration, geriatric conditions impair heart failure self-care, which subsequently may result in hospitalization and mortality. Hospitalization can further worsen impairments; for example, being confined to bed can exacerbate frailty, and delirium can precipitate falls.