Geriatric Cardiology: Coming of Age

• Type of Material: Article
• Authors: Parag Goyal, Weill Cornell Medicine; Min Ji Kwak, McGovern Medical School; Christina Al Malouf, Icahn School of Medicine; Manish Kumar, University of Connecticut; Namit Rohant, University of Arizona; Abdulla A. Damulji, Inova Center of Outcomes Research; Quin E. Denfeld, Oregon Health and Science University; Kim K. Bircher, University of Houston; Ashok Krishnaswami, Stanford University; Karen P. Alexander, Duke University; Daniel E. Forman, University of Pittsburgh; Michael W. Rich, Washington University in St. Louis; Nanette Kass Wenger, Emory University; James N. Kirkpatrick, University of Washington; Jerome L. Fleg, National Heart, Lung, and Blood Institute
• Language: English
• Date: 2022-08-26
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2022 The Authors
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): https://doi.org/10.1016%2Fj.jacadv.2022.100070
• Title of Journal or Parent Work: JACC Advances
• Volume: 1
• Issue: 3
• Start Page: 100070
• Grant/Funding Information: National Heart, Lung, and Blood Institute, National Institutes of Health, or the United States Department of Health and Human Services.
• Keywords: multimorbidity; cognitive impairment; polypharmacy; geriatric cardiology; patient-centered care; frailty
• Research Categories: Health Sciences, Health Care Management; Psychology, Cognitive

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.