TY - JOUR
T1 - Interventions for Frailty Among Older Adults With Cardiovascular Disease
T2 - JACC State-of-the-Art Review
AU - Ijaz, Naila
AU - Buta, Brian
AU - Xue, Qian Li
AU - Mohess, Denise T.
AU - Bushan, Archana
AU - Tran, Henry
AU - Batchelor, Wayne
AU - deFilippi, Christopher R.
AU - Walston, Jeremy D.
AU - Bandeen-Roche, Karen
AU - Forman, Daniel E.
AU - Resar, Jon R.
AU - O'Connor, Christopher M.
AU - Gerstenblith, Gary
AU - Damluji, Abdulla A.
N1 - Publisher Copyright:
© 2022 The Authors
PY - 2022/2/8
Y1 - 2022/2/8
N2 - With the aging of the world's population, a large proportion of patients seen in cardiovascular practice are older adults, but many patients also exhibit signs of physical frailty. Cardiovascular disease and frailty are interdependent and have the same physiological underpinning that predisposes to the progression of both disease processes. Frailty can be defined as a phenomenon of increased vulnerability to stressors due to decreased physiological reserves in older patients and thus leads to poor clinical outcomes after cardiovascular insults. There are various pathophysiologic mechanisms for the development of frailty: cognitive decline, physical inactivity, poor nutrition, and lack of social supports; these risk factors provide opportunity for various types of interventions that aim to prevent, improve, or reverse the development of frailty syndrome in the context of cardiovascular disease. There is no compelling study demonstrating a successful intervention to improve a global measure of frailty. Emerging data from patients admitted with heart failure indicate that interventions associated with positive outcomes on frailty and physical function are multidimensional and include tailored cardiac rehabilitation. Contemporary cardiovascular practice should actively identify patients with physical frailty who could benefit from frailty interventions and aim to deliver these therapies in a patient-centered model to optimize quality of life, particularly after cardiovascular interventions.
AB - With the aging of the world's population, a large proportion of patients seen in cardiovascular practice are older adults, but many patients also exhibit signs of physical frailty. Cardiovascular disease and frailty are interdependent and have the same physiological underpinning that predisposes to the progression of both disease processes. Frailty can be defined as a phenomenon of increased vulnerability to stressors due to decreased physiological reserves in older patients and thus leads to poor clinical outcomes after cardiovascular insults. There are various pathophysiologic mechanisms for the development of frailty: cognitive decline, physical inactivity, poor nutrition, and lack of social supports; these risk factors provide opportunity for various types of interventions that aim to prevent, improve, or reverse the development of frailty syndrome in the context of cardiovascular disease. There is no compelling study demonstrating a successful intervention to improve a global measure of frailty. Emerging data from patients admitted with heart failure indicate that interventions associated with positive outcomes on frailty and physical function are multidimensional and include tailored cardiac rehabilitation. Contemporary cardiovascular practice should actively identify patients with physical frailty who could benefit from frailty interventions and aim to deliver these therapies in a patient-centered model to optimize quality of life, particularly after cardiovascular interventions.
KW - aging
KW - cardiovascular disease
KW - frailty
KW - interventions
KW - older adult
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U2 - 10.1016/j.jacc.2021.11.029
DO - 10.1016/j.jacc.2021.11.029
M3 - Review article
C2 - 35115105
AN - SCOPUS:85123089668
SN - 0735-1097
VL - 79
SP - 482
EP - 503
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 5
ER -