Geriatric Cardiology: Coming of Age

Authors

Parag Goyal
Min Ji Kwak
Christina Al Malouf
Manish Kumar
Namit Rohant
Abdulla A Damluji
Quin E Denfeld
Kim K Bircher
Ashok Krishnaswami
Karen P Alexander
Daniel E Forman
Michael W Rich
Nanette K Wenger
James N Kirkpatrick
Jerome L Fleg

Publication Date

8-1-2022

Journal

JACC: Advances

Abstract

Older adults with cardiovascular disease (CVD) contend with deficits across multiple domains of health due to age-related physiological changes and the impact of CVD. Multimorbidity, polypharmacy, cognitive changes, and diminished functional capacity, along with changes in the social environment, result in complexity that makes provision of CVD care to older adults challenging. In this review, we first describe the history of geriatric cardiology, an orientation that acknowledges the unique needs of older adults with CVD. Then, we introduce 5 essential principles for meeting the needs of older adults with CVD: 1) recognize and consider the potential impact of multicomplexity; 2) evaluate and integrate constructs of cognition into decision-making; 3) evaluate and integrate physical function into decision-making; 4) incorporate social environmental factors into management decisions; and 5) elicit patient priorities and health goals and align with care plan. Finally, we review future steps to maximize care provision to this growing population.

Keywords

cognitive impairment, frailty, geriatric cardiology, multimorbidity, patient-centered care, polypharmacy