Frailty in older adults with heart disease.

Abstract

Heart failure prevalence will double in the next 40years and affects more than 10% of persons over the age of 70years in an age-dependent manner. Frailty is an age-associated clinical syndrome defined as adecrease in physiological reserve in situations of stress, such as operations, infections and acute illness based on astate of higher vulnerability. The prevalence is up to 74% in older individuals over the age of 80years or those over 70years old with ahigh burden of comorbidities and chronic diseases. This geriatric syndrome is associated with aworse clinical outcome and higher morbidity and mortality in acute and chronic disease than in age-matched cohorts without this syndrome. In this brief review, the scientific evidence of appropriate tools for diagnosis of frailty in heart failure patients is addressed. Heart failure management in this special group of patients requires aholistic care planning presented here in accordance with pathophysiologic particularities. Aliterature search in PubMed using the terms "heart failure" and "frailty" was carried out and afurther search in the references based on the findings. The diagnosis of frailty should influence the intensity of further diagnostic investigations and medical treatment based on the personal wishes of the patient, reduced organ reserves and general prognosis. The prognosis of heart failure patients remains poor, partially due to the intertwining with frailty. Aclear statement for the use of an appropriate diagnostic tool for frailty and heart failure and specific therapeutic recommendations are presented based on clinical evidence.