Domain Management Approach to Heart Failure in the Geriatric Patient: Present and Future

Overview

Journal J Am Coll Cardiol

Specialty Cardiology & Vascular Diseases

Date 2018 Apr 28

PMID 29699619

Citations 110

Authors

Eiran Z Gorodeski

Parag Goyal

Scott L Hummel

Ashok Krishnaswami

Sarah J Goodlin

Linda L Hart

Daniel E Forman

Nanette K Wenger

James N Kirkpatrick

Karen P Alexander

Affiliations

Soon will be listed here.

Abstract

Heart failure (HF) is a quintessential geriatric cardiovascular condition, with more than 50% of hospitalizations occurring in adults age 75 years or older. In older patients, HF is closely linked to processes inherent to aging, which include cellular and structural changes to the myocardium, vasculature, and skeletal muscle. In addition, HF cannot be considered in isolation of physical functioning, or without the social, psychological, and behavioral dimensions of illness. The role of frailty, depression, cognitive impairment, nutrition, and goals of care are each uniquely relevant to the implementation and success of medical therapy. In this paper, we discuss a model of caring for older adults with HF through a 4-domain framework that can address the unique multidimensional needs and vulnerabilities of this population. We believe that clinicians who embrace this approach can improve health outcomes for older adults with HF.

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