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Heart failure in very old adults
Daniel E Forman1, Ali Ahmed, Jerome L Fleg
1Division of Cardiovascular Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA, deforman@partners.org.
Current Heart Failure Reports
|October 5, 2013
Summary
Heart failure (HF) management in older adults is complex due to age-related changes and comorbidities. Current therapies offer limited benefits, shifting focus towards improving quality of life and independence.
Area of Science:
- Gerontology
- Cardiology
- Internal Medicine
Background:
- Heart failure (HF) prevalence significantly increases with age.
- Aging involves cardiovascular changes and comorbidities (e.g., renal insufficiency, COPD) that exacerbate HF.
- Standard HF therapies have limited efficacy in addressing age-related pathophysiology.
Purpose of the Study:
- To review age-related susceptibility to heart failure.
- To evaluate the utility and limitations of standard HF management strategies in older adults.
- To consider both HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF).
Main Methods:
- Literature review focusing on aging and heart failure.
- Analysis of standard pharmacological and device-based HF therapies.
- Consideration of patient-centered goals beyond life prolongation.
Main Results:
- Age-related cardiovascular changes and comorbidities complicate HF management.
- Standard HF treatments show limited impact on the underlying aging processes.
- Quality of life, physical/cognitive function, and independence are key priorities for older HF patients.
Conclusions:
- HF management in the elderly requires tailored approaches beyond standard protocols.
- Therapeutic goals for older adults with HF may prioritize functional status and independence over solely life extension.
- Further research is needed to optimize HF care for the aging population.
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