Interventions for Frailty Among Older Adults With Cardiovascular Disease

Ijaz, Naila; Buta, Brian; Xue, Qian‐Li; Mohess, Denise; Bushan, Archana; Tran, Henry A.; Batchelor, Wayne; deFilippi, Christopher R.; Walston, Jeremy D.; Bandeen‐Roche, Karen; Forman, Daniel E.; Resar, Jon R.; O’Connor, Christopher M; Gerstenblith, Gary; Damluji, Abdulla

doi:10.1016/j.jacc.2021.11.029

Cited by 131 publications

(68 citation statements)

References 108 publications

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“…During the COVID-19 pandemic, several frail patients became isolated at home with detrimental consequences in terms of their functional status and social participation [ 58 , 59 ]. Therefore, in recent years a growing interest in telehealth and telerehabilitation solutions that might improve healthcare delivery in frail patients is observed [ 60 , 61 , 62 ].…”

Section: Telemedicine and Technological Innovation To Overcome The Ba...mentioning

confidence: 99%

Closing the Gap between Inpatient and Outpatient Settings: Integrating Pulmonary Rehabilitation and Technological Advances in the Comprehensive Management of Frail Patients

Lippi

D’Abrosca

Folli

et al. 2022

IJERPH

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Pulmonary rehabilitation (PR) is a well-established intervention supported by strong evidence that is used to treat patients affected by chronic respiratory diseases. However, several barriers still affect its spreading in rehabilitation clinical practices. Although chronic respiratory diseases are common age-related disorders, there is still a gap of knowledge regarding the implementation of sustainable strategies integrating PR in the rehabilitation management of frail patients at high risk of respiratory complications. Therefore, in the present study, we characterized the effects of PR in frail patients, highlighting the evidence supporting its role in improving the complex rehabilitative management of these patients. Moreover, we propose a novel organizational model promoting PR programs for frail patients in both inpatient and outpatient settings. Our model emphasizes the role of interdisciplinary care, specifically tailored to patients and environmental characteristics. In this scenario, cutting-edge technology and telemedicine solutions might be implemented as safe and sustainable strategies filling the gap between inpatient and outpatient settings. Future research should focus on large-scale sustainable interventions to improve the quality of life and global health of frail patients. Moreover, evidence-based therapeutic paths should be promoted and taught in training courses promoting multiprofessional PR knowledge to increase awareness and better address its delivery in frail patients.

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Section: Telemedicine and Technological Innovation To Overcome The Ba...mentioning

confidence: 99%

Closing the Gap between Inpatient and Outpatient Settings: Integrating Pulmonary Rehabilitation and Technological Advances in the Comprehensive Management of Frail Patients

Lippi

D’Abrosca

Folli

et al. 2022

IJERPH

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“…Geriatric syndromes such as functional dependence, cognitive impairment and malnutrition are in most cases caused by physical frailty which implies decreased muscle strength, a loss of endurance, decreased physiological function and a decreased ability to adapt to stress. Studies have shown clear interactions between frailty status and the complications of coronary heart disease [ 2 , 8 , 9 ]. Therefore, the evaluation of frailty in seniors has become an indirect way of assessing the true adverse events associated with chronic coronary syndromes.…”

Section: Introductionmentioning

confidence: 99%

“…However, there is a predominant tendency in current studies to speculate on a one-way relationship between CCSs and frailty, so it seems that cardiovascular damage predisposes to frailty rather than vice versa [ 8 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Chronic Coronary Syndrome in Frail Old Population

Ilie

Țăranu

Ștefăniu

et al. 2022

Life

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The demographic trend of aging is associated with an increased prevalence of comorbidities among the elderly. Physical, immunological, emotional and cognitive impairment, in the context of the advanced biological age segment, leads to the maintenance and precipitation of cardiovascular diseases. Thus, more and more data are focused on understanding the pathophysiological mechanisms underlying each fragility phenotype and how they potentiate each other. The implications of inflammation, sarcopenia, vitamin D deficiency and albumin, as dimensions inherent in fragility, in the development and setting of chronic coronary syndromes (CCSs) have proven their patent significance but are still open to research. At the same time, the literature speculates on the interdependent relationship between frailty and CCSs, revealing the role of the first one in the development of the second. In this sense, depression, disabilities, polypharmacy and even cognitive disorders in the elderly with ischemic cardiovascular disease mean a gradual and complex progression of frailty. The battery of tests necessary for the evaluation of the elderly with CCSs requires a permanent update, according to the latest guidelines, but also an individualized approach related to the degree of frailty and the conditions imposed by it. By summation, the knowledge of frailty screening methods, through the use of sensitive and individualized tools, is the foundation of secondary prevention and prognosis in the elderly with CCSs. Moreover, a comprehensive geriatric assessment remains the gold standard of the medical approach of these patients. The management of the frail elderly, with CCSs, brings new challenges, also from the perspective of the treatment particularities. Sometimes the risk–benefit balance is difficult to achieve. Therefore, the holistic, individualized and updated approach of these patients remains a desired objective, by understanding and permanently acquiring knowledge on the complexity of the frailty syndrome.

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“…Social isolation accompanying aging accelerates frailty and worsens chronic health issues ( 14 ). Lack of social support is one of the various pathophysiologic mechanisms for the development of frailty ( 12 ). Several underlying pathways of social support on frailty have been explored ( 15 , 16 ).…”

Section: Introductionmentioning

confidence: 99%

“…Social support is the perception and actuality that one is cared for by others, which is meaningful and will provide care for frail people (10). Previous studies have demonstrated associations between social support and frailty (11)(12)(13). A study from the USA found that, for older adults who were already frail, increased social support was related to less-steep increases in frailty (13).…”

Section: Introductionmentioning

confidence: 99%

Perceived Social Support and Associated Factors Among Community-Dwelling Older Adults With Frailty and Pre-frailty in Hangzhou, China

Fang

Ren²,

Ren³

et al. 2022

Front. Psychiatry

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Objectives:The present study aimed to explore the social support among community-dwelling older adults with frailty and pre-frailty and to ascertain associated factors.MethodsThe frailty status of the participant was assessed via the Chinese FRAIL Scale. The dependent variable, level of social support, was evaluated using the Social Support Rating Scale (range: 12–66). This study explored the influencing factors from three aspects containing sociodemographic characteristics, family environment, and community environment. Independent-sample t-test, Analysis of Variance, and multiple linear regression analyses were conducted to examine determinants of social support.ResultsThere were significant differences in overall social support between non-frail, pre-frail, and frail participants [38.01 (SD = 6.48) vs. 33.62 (SD = 6.25) vs. 30.50 (SD = 6.68), F = 62.157, p < 0.001]. Older adults with frailty and pre-frailty who were single would have lower levels of overall social support. In the pre-frail group, living alone was associated with lower overall social support. In contrast, the relationship with children and the availability of recreational activities were associated factors for the frail group.ConclusionsThe level of social support among frail and pre-frail community-dwelling older adults was lower than the robust older adults and influenced by different factors according to the frailty category, which suggests taking targeted measures for social support improvement.

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Interventions for Frailty Among Older Adults With Cardiovascular Disease

Cited by 131 publications

References 108 publications

Closing the Gap between Inpatient and Outpatient Settings: Integrating Pulmonary Rehabilitation and Technological Advances in the Comprehensive Management of Frail Patients

Closing the Gap between Inpatient and Outpatient Settings: Integrating Pulmonary Rehabilitation and Technological Advances in the Comprehensive Management of Frail Patients

Chronic Coronary Syndrome in Frail Old Population

Perceived Social Support and Associated Factors Among Community-Dwelling Older Adults With Frailty and Pre-frailty in Hangzhou, China

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