TY - JOUR
T1 - Frailty Is Intertwined With Heart Failure
T2 - Mechanisms, Prevalence, Prognosis, Assessment, and Management
AU - Pandey, Ambarish
AU - Kitzman, Dalane
AU - Reeves, Gordon
N1 - Publisher Copyright:
© 2019 American College of Cardiology Foundation
PY - 2019/12
Y1 - 2019/12
N2 - Frailty, a syndrome characterized by an exaggerated decline in function and reserve of multiple physiological systems, is common in older patients with heart failure (HF) and is associated with worse clinical and patient-reported outcomes. Although several detailed assessment tools have been developed and validated in the geriatric population, they are cumbersome, not validated in patients with HF, and not commonly used in routine management of patients with HF. More recently, there has been an increasing interest in developing simple frailty screening tools that could efficiently and quickly identify frail patients with HF in routine clinical settings. As the burden and recognition of frailty in older patients with HF increase, a more comprehensive approach to management is needed that targets deficits across multiple domains, including physical function and medical, cognitive, and social domains. Such a multidomain approach is critical to address the unique, multidimensional challenges to the care of these high-risk patients and to improve their functional status, quality of life, and long-term clinical outcomes. This review discusses the burden of frailty, the conceptual underpinnings of frailty in older patients with HF, and potential strategies for the assessment, screening, and management of frailty in this vulnerable patient population.
AB - Frailty, a syndrome characterized by an exaggerated decline in function and reserve of multiple physiological systems, is common in older patients with heart failure (HF) and is associated with worse clinical and patient-reported outcomes. Although several detailed assessment tools have been developed and validated in the geriatric population, they are cumbersome, not validated in patients with HF, and not commonly used in routine management of patients with HF. More recently, there has been an increasing interest in developing simple frailty screening tools that could efficiently and quickly identify frail patients with HF in routine clinical settings. As the burden and recognition of frailty in older patients with HF increase, a more comprehensive approach to management is needed that targets deficits across multiple domains, including physical function and medical, cognitive, and social domains. Such a multidomain approach is critical to address the unique, multidimensional challenges to the care of these high-risk patients and to improve their functional status, quality of life, and long-term clinical outcomes. This review discusses the burden of frailty, the conceptual underpinnings of frailty in older patients with HF, and potential strategies for the assessment, screening, and management of frailty in this vulnerable patient population.
KW - Fried phenotype
KW - aging
KW - frailty
KW - heart failure
KW - physical function
KW - quality of life
UR - http://www.scopus.com/inward/record.url?scp=85075006583&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85075006583&partnerID=8YFLogxK
U2 - 10.1016/j.jchf.2019.10.005
DO - 10.1016/j.jchf.2019.10.005
M3 - Review article
C2 - 31779921
AN - SCOPUS:85075006583
SN - 2213-1779
VL - 7
SP - 1001
EP - 1011
JO - JACC: Heart Failure
JF - JACC: Heart Failure
IS - 12
ER -