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Domain Management Approach to Heart Failure in the Geriatric Patient: Present and Future.


ABSTRACT: Heart failure (HF) is a quintessential geriatric cardiovascular condition, with more than 50% of hospitalizations occurring in adults age 75 years or older. In older patients, HF is closely linked to processes inherent to aging, which include cellular and structural changes to the myocardium, vasculature, and skeletal muscle. In addition, HF cannot be considered in isolation of physical functioning, or without the social, psychological, and behavioral dimensions of illness. The role of frailty, depression, cognitive impairment, nutrition, and goals of care are each uniquely relevant to the implementation and success of medical therapy. In this paper, we discuss a model of caring for older adults with HF through a 4-domain framework that can address the unique multidimensional needs and vulnerabilities of this population. We believe that clinicians who embrace this approach can improve health outcomes for older adults with HF.

SUBMITTER: Gorodeski EZ 

PROVIDER: S-EPMC7304050 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature

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Domain Management Approach to Heart Failure in the Geriatric Patient: Present and Future.

Gorodeski Eiran Z EZ   Goyal Parag P   Hummel Scott L SL   Krishnaswami Ashok A   Goodlin Sarah J SJ   Hart Linda L LL   Forman Daniel E DE   Wenger Nanette K NK   Kirkpatrick James N JN   Alexander Karen P KP  

Journal of the American College of Cardiology 20180501 17


Heart failure (HF) is a quintessential geriatric cardiovascular condition, with more than 50% of hospitalizations occurring in adults age 75 years or older. In older patients, HF is closely linked to processes inherent to aging, which include cellular and structural changes to the myocardium, vasculature, and skeletal muscle. In addition, HF cannot be considered in isolation of physical functioning, or without the social, psychological, and behavioral dimensions of illness. The role of frailty,  ...[more]

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