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Prognostic and Therapeutic Implications of Frailty in Older Adults with Heart Failure

  • Heart Failure (MR Mehra and E Joyce, Section Editors)
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Abstract

Frailty is increasingly recognized in older adults with cardiovascular disease, particularly in those with heart failure (HF). A growing body of evidence has shown that frailty has a negative effect on survival, hospitalizations, disability, and quality of life. Beyond frailty, additional domains captured by a comprehensive geriatric assessment contribute incremental value in predicting outcomes and identifying treatment targets. Exercise training is ideally suited to this setting as it can concomitantly improve physical frailty and HF symptoms. Multidisciplinary disease management programs offer a number of benefits for frail HF patients; invasive procedures carry a higher risk of morbidity than in non-frail counterparts, and evidence-based drugs and devices have an uncertain value and warrant further research. While more data accrues, difficult therapeutic decisions should be individualized using a shared patient-centered decision making approach.

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Conflict of Interest

Michael Goldfarb, Richard Sheppard, and Jonathan Afilalo declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Division of Cardiology, Jewish General Hospital, McGill University, 3755 Cote Ste Catherine Rd, Montreal, QC, H3T 1E2, Canada

    Michael Goldfarb, Richard Sheppard & Jonathan Afilalo

  2. Centre for Clinical Epidemiology, Lady Davis Institute, McGill University, 3755 Cote Ste Catherine Rd, E-222, Montreal, QC, H3T 1E2, Canada

    Jonathan Afilalo

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  1. Michael Goldfarb
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  2. Richard Sheppard
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Correspondence to Jonathan Afilalo.

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This article is part of the Topical Collection on Heart Failure

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Goldfarb, M., Sheppard, R. & Afilalo, J. Prognostic and Therapeutic Implications of Frailty in Older Adults with Heart Failure. Curr Cardiol Rep 17, 92 (2015). https://doi.org/10.1007/s11886-015-0651-3

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  • DOI: https://doi.org/10.1007/s11886-015-0651-3

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