[Geriatric assessment in the elderly with heart failure]

Despite recent advances in pharmacotherapy, heart failure represents the major cause of death and hospitalization for elderly people in developed countries. Clinical assessment and management of older patients are often more difficult than in younger ones. Epidemiological studies in geriatrics as well as cardiology setting have demonstrated that elderly heart failure patients are frail and complex individuals, in whom many clinical and non-clinical factors may play a role in determining clinical presentation and prognosis. Thus, management of heart failure in the elderly requires a coordinated, multidimensional and multidisciplinary approach. This article describes the principles of geriatric assessment. Assessment should include the evaluation of comorbidity, cognitive status, functional ability in activities of daily living, psychosocial, environmental and financial factors, and quality of life. Available evidence suggests that geriatric assessment can have a positive effect on patient outcome and overall quality and cost of care.