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Cognitive Impairment and Frailty in Older Adults With Cardiovascular Disease: 2026 ACC Scientific Statement: A Report

Karen P Alexander, Abdulla A Damluji, Sebhat Erqou

    Journal of the American College of Cardiology
    |August 10, 2026
    PubMed

    Insights

    Cardiovascular disease (CVD), cognitive impairment, and frailty are linked in older adults due to shared aging processes. Addressing common risk factors and promoting resilience can improve health outcomes.

    Area of Science:

    • Gerontology
    • Cardiology
    • Neurology

    Background:

    • Cardiovascular disease (CVD) in older adults often coexists with cognitive impairment, frailty, and physical disability.
    • These conditions collectively influence health and functional trajectories in later life.
    • Biological aging contributes to vascular dysfunction, chronic inflammation, and sarcopenia, exacerbating these issues.

    Purpose of the Study:

    • To review the intersections among CVD, cognitive impairment, and frailty in older adults.
    • To highlight the role of biological aging in these interconnected conditions.
    • To summarize consensus-based approaches for prevention, assessment, and management.

    Main Methods:

    • This is a Scientific Statement from the American College of Cardiology.
    • It involves a review of existing literature and expert consensus.
    • Focuses on practical approaches for clinical care.

    Main Results:

    • CVD, cognitive impairment, and frailty are viewed as manifestations of shared biological aging.
    • Key recommendations include targeting common, modifiable risk factors.
    • Promoting resilience through medication, exercise, nutrition, and limiting polypharmacy is advised.

    Conclusions:

    • Integrated care approaches are needed for older adults with CVD, cognitive impairment, and frailty.
    • There is a need for increased consideration of these interconnected conditions in clinical care and research.
    • Current recommendations are based on limited evidence, highlighting a need for further investigation.

    Keywords:
    ACC Scientific Statementcardiovascular diseasecognitive impairmentdementiafrailtyolder adultsprevention

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