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Chronological vs Biological Age in Interventional Cardiology: A Comprehensive Approach to Care for Older Adults:
Abdulla A Damluji1, Michael G Nanna2, Jennifer Rymer3
1Inova Center of Outcomes Research, Fairfax, Virginia, USA; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Insights
As the global population ages, interventional cardiology faces increasing complexity in treating older adults. This review highlights age-related risks and strategies to optimize cardiovascular care for elderly patients undergoing invasive procedures.
Area of Science:
- Cardiology
- Geriatrics
- Interventional Cardiology
Background:
- Aging populations globally increase the demand for complex cardiovascular care in older adults.
- Interventional cardiologists must navigate age-associated risks impacting procedural decisions and outcomes.
- Transcatheter interventions for structural heart disease in the elderly highlight the importance of age-related considerations.
Purpose of the Study:
- To provide a comprehensive overview of aging in relation to cardiovascular interventions.
- To emphasize the distinction between chronological and biological aging in patient care.
- To discuss strategies for improving health outcomes in older adults undergoing invasive cardiovascular procedures.
Main Methods:
- State-of-the-art review of current literature on aging and interventional cardiology.
- Analysis of age-related risks, decision-making factors, and procedural outcomes.
- Discussion of gerotherapeutics, biological aging assessment, and patient-centered outcomes.
Main Results:
- Aging significantly influences eligibility, decision-making, adverse events, and long-term management in interventional cardiology.
- Understanding biological aging is crucial for tailoring cardiovascular interventions in older adults.
- Technological advancements and gerotherapeutics offer potential to improve care.
Conclusions:
- Interventional cardiology must adapt to the complexities of an aging population.
- Integrating biological aging assessments and patient-centered outcomes is vital for optimizing care.
- Future directions include advancing gerotherapeutics and technological innovations for elderly cardiovascular patients.
Abstract:
Aging is the gradual decline in physical and physiological functioning leading to increased susceptibility to stressors and chronic illnesses, including cardiovascular disease. With an aging global population, in which 1 in 6 individuals will be older than 60 years by 2030, interventional cardiologists are increasingly involved in providing complex care for older individuals. Although procedural aspects remain their main clinical focus, interventionalists frequently encounter age-associated risks that influence eligibility for invasive care, decision making during the intervention, procedural adverse events, and long-term management decisions. The unprecedented growth in transcatheter interventions, especially for structural heart diseases at extremes of age, have pushed age-related risks and implications for cardiovascular care to the forefront. In this JACC state-of-the-art review, the authors provide a comprehensive overview of the aging process as it relates to cardiovascular interventions, with special emphasis on the difference between chronological and biological aging. The authors also address key considerations to improve health outcomes for older patients during and after their invasive cardiovascular care. The role of "gerotherapeutics" in interventional cardiology, technological innovation in measuring biological aging, and the integration of patient-centered outcomes in the older adult population are also discussed.
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