High Prevalence of Geriatric Conditions Among Older Adults With Cardiovascular Disease

Abstract

As the population ages, the global cardiovascular disease burden will continue to increase, particularly among older adults. Increases in life expectancy and better cardiovascular care have significantly reshaped the epidemiology of cardiovascular disease and have created new patient profiles. The combination of older age, multiple comorbidities, polypharmacy, frailty, and adverse noncardiovascular outcomes is challenging our routine clinical practice in this field. In this review, we examine noncardiovascular factors that statistically interact in a relevant way with health status and quality of life in older people with cardiovascular disease. We focused on specific geriatric conditions (multimorbidity, polypharmacy, geriatric syndromes, and frailty) that are responsible for a major risk of functional decline and have an important impact on the overall prognosis in this patient population.

Awaiting the verdict: Statins and the road ahead for primary prevention in older adults

“…In the United States, CVD was responsible for approximately 929,000 deaths in 2020, accounting for 1 in every 3.6 deaths 1 . Beyond its impact on mortality, CVD significantly contributes to disability among older adults, resulting in an approximate six‐year reduction in “healthspan”—defined as life with good health and function—for people aged 65 and older 1,2 . It is estimated that 70% of individuals aged 70 and above will develop CVD, implying that primary prevention strategies, such as the use of statins for lipid‐lowering, are critical even in patients of advanced age 2 .…”

“…Beyond its impact on mortality, CVD significantly contributes to disability among older adults, resulting in an approximate six‐year reduction in “healthspan”—defined as life with good health and function—for people aged 65 and older 1,2 . It is estimated that 70% of individuals aged 70 and above will develop CVD, implying that primary prevention strategies, such as the use of statins for lipid‐lowering, are critical even in patients of advanced age 2 . Despite the extensive evidence supporting the use of statins for primary prevention in adults up to age 75, beyond that point, there are limited data from randomized trials, leading to IIb recommendations in the current guidelines that it may be reasonable to both initiate, or potentially deprescribe a statin, depending on frailty, multimorbidity, functional decline, or other factors that may limit life expectancy 3 .…”

“…1,2 It is estimated that 70% of individuals aged 70 and above will develop CVD, implying that primary prevention strategies, such as the use of statins for lipid-lowering, are critical even in patients of advanced age. 2 Despite the extensive evidence supporting the use of statins for primary prevention in adults up to age 75, beyond that point, there are limited data from randomized trials, leading to IIb recommendations in the current guidelines that it may be reasonable to both initiate, or potentially deprescribe a statin, depending on frailty, multimorbidity, functional decline, or other factors that may limit life expectancy. 3 This uncertainty about the role of statins in primary prevention represents a significant public health gap, particularly considering the heterogeneity of older adults, where clinicians encounter a spectrum from robust, independent individuals to those who are frail or dependent on assistance for self-care activities.…”

Establishment and validation of a risk prediction model for the occurrence of frailty in elderly patients with heart failure with preserved ejection fraction

“…Geriatric frailty shares similar clinical features with HFpEF, with common risk factors and shared clinical intervention targets. Some propose that HFpEF could also be considered a geriatric syndrome12 .…”

Geriatric cardiology: general provisions

“…Поліфармацію визначають як одночасне вживання  5 препаратів, надлишкову -10 і більше препаратів, що асоціюється з погіршанням перебігу наявних хвороб, зростанням побічних реакцій, госпіталізацій, інституалізації, смертності. В осіб 65 років і більше поліфармацію реєструють з частотою 26,3-40 % [2].…”