Gerotechnology for Older Adults With Cardiovascular Diseases: JACC State-of-the-Art Review

Overview

Journal J Am Coll Cardiol

Specialty Cardiology & Vascular Diseases

Date 2020 Nov 27

PMID 33243384

Citations 46

Authors

Ashok Krishnaswami

Craig Beavers

Michael P Dorsch

John A Dodson

Ruth Masterson Creber

Spyros Kitsiou

Parag Goyal

Mathew S Maurer

Nanette K Wenger

Deborah S Croy

Karen P Alexander

John A Batsis

Mintu P Turakhia

Daniel E Forman

Gwen M Bernacki

James N Kirkpatrick

Nicole M Orr

Eric D Peterson

Michael W Rich

Andrew M Freeman

Sanjeev P Bhavnani

Affiliations

Soon will be listed here.

Abstract

The growing population of older adults (age ≥65 years) is expected to lead to higher rates of cardiovascular disease. The expansion of digital health (encompassing telehealth, telemedicine, mobile health, and remote patient monitoring), Internet access, and cellular technologies provides an opportunity to enhance patient care and improve health outcomes-opportunities that are particularly relevant during the current coronavirus disease-2019 pandemic. Insufficient dexterity, visual impairment, and cognitive dysfunction, found commonly in older adults should be taken into consideration in the development and utilization of existing technologies. If not implemented strategically and appropriately, these can lead to inequities propagating digital divides among older adults, across disease severities and socioeconomic distributions. A systematic approach, therefore, is needed to study and implement digital health strategies in older adults. This review will focus on current knowledge of the benefits, barriers, and use of digital health in older adults for cardiovascular disease management.

Citing Articles

Leveraging Mobile Health and Wearable Technologies for the Prevention and Management of Atherosclerotic Cardiovascular Disease.

Alipour P, El-Aghil M, Foo A, Azizi Z Curr Atheroscler Rep. 2025; 27(1):31.

PMID: 39932603 DOI: 10.1007/s11883-024-01272-w.

Digital Health Interventions for the Optimization of Postpartum Cardiovascular Health: A Systematic Scoping Review.

Hausvater A, Pleasure M, Vieira D, Banco D, Dodson J Am J Prev Cardiol. 2025; 21():100917.

PMID: 39816980 PMC: 11733190. DOI: 10.1016/j.ajpc.2024.100917.

Patient-Centered mHealth Intervention to Improve Self-Care in Patients With Chronic Heart Failure: Phase 1 Randomized Controlled Trial.

Kitsiou S, Gerber B, Buchholz S, Kansal M, Sun J, Pressler S J Med Internet Res. 2025; 27:e55586.

PMID: 39813671 PMC: 11780297. DOI: 10.2196/55586.

Telemedicine use in Primary Care Associated with More Timely Access Without Unintended Subsequent Utilization for People with Dementia.

Adler-Milstein J, Gopalan A, Huang J, Toretsky C, Reed M J Gen Intern Med. 2024; .

PMID: 39557755 DOI: 10.1007/s11606-024-09211-w.

Remote Patient Monitoring and Digital Therapeutics Enhancing the Continuum of Care in Heart Failure: Nonrandomized Pilot Study.

Marier-Tetrault E, Bebawi E, Bechard S, Brouillard P, Zuchinali P, Remillard E JMIR Form Res. 2024; 8:e53444.

PMID: 39504548 PMC: 11579625. DOI: 10.2196/53444.

References

Ward Z, Bleich S, Cradock A, Barrett J, Giles C, Flax C . Projected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity. N Engl J Med. 2019; 381(25):2440-2450. DOI: 10.1056/NEJMsa1909301. View

Gandapur Y, Kianoush S, Kelli H, Misra S, Urrea B, Blaha M . The role of mHealth for improving medication adherence in patients with cardiovascular disease: a systematic review. Eur Heart J Qual Care Clin Outcomes. 2018; 2(4):237-244. PMC: 5862021. DOI: 10.1093/ehjqcco/qcw018. View

Abroms L, Padmanabhan N, Thaweethai L, Phillips T . iPhone apps for smoking cessation: a content analysis. Am J Prev Med. 2011; 40(3):279-85. PMC: 3395318. DOI: 10.1016/j.amepre.2010.10.032. View

Richard E, Jongstra S, Soininen H, Brayne C, Moll van Charante E, Meiller Y . Healthy Ageing Through Internet Counselling in the Elderly: the HATICE randomised controlled trial for the prevention of cardiovascular disease and cognitive impairment. BMJ Open. 2016; 6(6):e010806. PMC: 4908903. DOI: 10.1136/bmjopen-2015-010806. View

Redfern J . Can Older Adults Benefit from Smart Devices, Wearables, and Other Digital Health Options to Enhance Cardiac Rehabilitation?. Clin Geriatr Med. 2019; 35(4):489-497. DOI: 10.1016/j.cger.2019.07.004. View

Bhavnani S, Narula J, Sengupta P . Mobile technology and the digitization of healthcare. Eur Heart J. 2016; 37(18):1428-38. PMC: 4914890. DOI: 10.1093/eurheartj/ehv770. View

Sarfo F, Ulasavets U, Opare-Sem O, Ovbiagele B . Tele-Rehabilitation after Stroke: An Updated Systematic Review of the Literature. J Stroke Cerebrovasc Dis. 2018; 27(9):2306-2318. PMC: 6087671. DOI: 10.1016/j.jstrokecerebrovasdis.2018.05.013. View

Koehler F, Koehler K, Deckwart O, Prescher S, Wegscheider K, Kirwan B . Efficacy of telemedical interventional management in patients with heart failure (TIM-HF2): a randomised, controlled, parallel-group, unmasked trial. Lancet. 2018; 392(10152):1047-1057. DOI: 10.1016/S0140-6736(18)31880-4. View

Boudreaux E, Waring M, Hayes R, Sadasivam R, Mullen S, Pagoto S . Evaluating and selecting mobile health apps: strategies for healthcare providers and healthcare organizations. Transl Behav Med. 2015; 4(4):363-71. PMC: 4286553. DOI: 10.1007/s13142-014-0293-9. View

10.

Tinetti M, Naik A, Dodson J . Moving From Disease-Centered to Patient Goals-Directed Care for Patients With Multiple Chronic Conditions: Patient Value-Based Care. JAMA Cardiol. 2016; 1(1):9-10. PMC: 6995667. DOI: 10.1001/jamacardio.2015.0248. View

11.

Berg N, Schumann M, Kraft K, Hoffmann W . Telemedicine and telecare for older patients--a systematic review. Maturitas. 2012; 73(2):94-114. DOI: 10.1016/j.maturitas.2012.06.010. View

12.

Powell A, Landman A, Bates D . In search of a few good apps. JAMA. 2014; 311(18):1851-2. DOI: 10.1001/jama.2014.2564. View

13.

Bergmann J, Chandaria V, McGregor A . Wearable and implantable sensors: the patient's perspective. Sensors (Basel). 2013; 12(12):16695-709. PMC: 3571806. DOI: 10.3390/s121216695. View

14.

Thomas R, Beatty A, Beckie T, Brewer L, Brown T, Forman D . Home-Based Cardiac Rehabilitation: A Scientific Statement From the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology. J Am Coll Cardiol. 2019; 74(1):133-153. PMC: 7341112. DOI: 10.1016/j.jacc.2019.03.008. View

15.

. Remote Monitoring of Implantable Cardioverter-Defibrillators, Cardiac Resynchronization Therapy and Permanent Pacemakers: A Health Technology Assessment. Ont Health Technol Assess Ser. 2018; 18(7):1-199. PMC: 6235077. View

16.

Bostrom J, Sweeney G, Whiteson J, Dodson J . Mobile health and cardiac rehabilitation in older adults. Clin Cardiol. 2019; 43(2):118-126. PMC: 7021651. DOI: 10.1002/clc.23306. View

17.

Baig M, GholamHosseini H, Moqeem A, Mirza F, Linden M . A Systematic Review of Wearable Patient Monitoring Systems - Current Challenges and Opportunities for Clinical Adoption. J Med Syst. 2017; 41(7):115. DOI: 10.1007/s10916-017-0760-1. View

18.

Bergmann J, McGregor A . Body-worn sensor design: what do patients and clinicians want?. Ann Biomed Eng. 2011; 39(9):2299-312. DOI: 10.1007/s10439-011-0339-9. View

19.

Perez M, Mahaffey K, Hedlin H, Rumsfeld J, Garcia A, Ferris T . Large-Scale Assessment of a Smartwatch to Identify Atrial Fibrillation. N Engl J Med. 2019; 381(20):1909-1917. PMC: 8112605. DOI: 10.1056/NEJMoa1901183. View

20.

Abnousi F, Rumsfeld J, Krumholz H . Social Determinants of Health in the Digital Age: Determining the Source Code for Nurture. JAMA. 2018; 321(3):247-248. DOI: 10.1001/jama.2018.19763. View