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TAVR in Older Adults: Moving Toward a Comprehensive Geriatric Assessment and Away From Chronological Age: JACC Family

Abdulla A Damluji1,2, Gwen Bernacki3,4,5, Jonathan Afilalo6

  • 1Inova Heart and Vascular Institute, Inova Center of Outcomes Research, Falls Church, Virginia, USA.

JACC. Advances
|May 2, 2024
PubMed

Insights

Calcific aortic stenosis in older adults requires a geriatric cardiology approach. Comprehensive assessment beyond chronological age, including frailty, improves risk stratification and patient-centered outcomes for aortic stenosis management.

Area of Science:

  • Geriatric Cardiology
  • Cardiovascular Disease in Aging Populations

Background:

  • Calcific aortic stenosis serves as a model for geriatric cardiovascular conditions.
  • Transcatheter aortic valve replacement (TAVR) was initially developed for high-risk older adults.
  • Chronological age alone is insufficient for risk stratification in elderly patients.

Purpose of the Study:

  • To review the diagnosis and management of aortic stenosis in older adults from a geriatric cardiology perspective.
  • To enhance shared decision-making and optimize patient-centered outcomes.
  • To identify knowledge gaps for future research in geriatric cardiovascular care.

Main Methods:

  • Review of current literature on aortic stenosis in older adults.
  • Application of a geriatric cardiology lens to diagnosis and management.
  • Focus on frailty and other geriatric risk factors beyond chronological age.

Main Results:

  • Risk stratification in older adults with aortic stenosis benefits from incorporating frailty and geriatric assessments.
  • A comprehensive approach is needed for optimal management.
  • Current methods of risk stratification require enhancement for the aging population.

Conclusions:

  • A geriatric cardiology approach is crucial for managing aortic stenosis in older adults.
  • Frailty and comprehensive geriatric assessments improve risk stratification.
  • Further research is needed to address knowledge gaps in this field.

Keywords:
TAVRagingbiological agecalcific aortic stenosischronological agecognitive functionfrailtypatient-centered outcomesphysical functionphysiological agequality of life

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