Age-specific differences in non-cardiac comorbidities among elderly patients hospitalized with heart failure: a special focus on young-old, old-old, and oldest-old

Abstract

Background Despite the growing epidemic of heart failure (HF), there is limited data available to systematically compare non-cardiac comorbidities in the young-old, old-old, and oldest-old patients hospitalized for HF. The precise differences will add valuable information for better management of HF in elderly patients. Methods A total of 1053 patients aged 65 years or older hospitalized with HF were included in this study. Patients were compared among three age groups: (1) young-old: 65 to 74 years, (2) old-old: 75 to 84 years, and (3) oldest-old: ≥85 years. Clinical details of presentation, comorbidities, and prescribed medications were recorded. Results The mean age was 76.7 years and 12.7% were 85 years or older. Most elderly patients with HF (97.5%) had at least one of the non-cardiac comorbidities. The patterns of common non-cardiac comorbidities were different between the young-old and oldest-old group. The three most common non-cardiac comorbidities were anemia (53.6%), hyperlipidemia (45.9%), and diabetes (42.4%) in the young-old group, while anemia (73.1%), infection (58.2%), and chronic kidney disease (44.0%) in the oldest-old group. Polypharmacy was observed in 93.0% elderly patients with HF. Additionally, 29.2% patients were diagnosed with infection, and 67.0% patients were prescribed antibiotics. However, 60.4% patients were diagnosed with anemia with only 8.9% of them receiving iron repletion. Conclusions Non-cardiac comorbidities are nearly universal in three groups but obviously differ by age, and inappropriate medications are very common in elderly patients with HF. Further treatment strategies should be focused on providing optimal medications for age-specific non-cardiac conditions.

Mildly symptomatic heart failure with reduced ejection fraction: diagnostic and therapeutic considerations

“…7 Clinical trials and real-world registries agree that the clinically stable mildly symptomatic HFrEF patient is a young-old (65-74 years old), overweight, male person with HF mainly due to ischaemic heart disease. 21,22 Despite the more favourable co-morbidity profile, this patient carries a considerable burden of coexisting conditions, more commonly coronary artery disease, hypertension, diabetes, atrial fibrillation, and chronic kidney disease. 9,23,24 The main symptom is dyspnoea on exertion and fatigue and less frequently overt signs or symptoms of HF, such as orthopnoea, paroxysmal nocturnal dyspnoea, dyspnoea at rest, peripheral oedema, and jugular vein distention.…”

“…Clinical trials and real‐world registries agree that the clinically stable mildly symptomatic HFrEF patient is a young‐old (65–74 years old), overweight, male person with HF mainly due to ischaemic heart disease 21,22 . Despite the more favourable co‐morbidity profile, this patient carries a considerable burden of coexisting conditions, more commonly coronary artery disease, hypertension, diabetes, atrial fibrillation, and chronic kidney disease 9,23,24 .…”

Subjective life expectancy of middle‐aged and older adult cancer survivors: A cross‐sectional study in Korea using age‐specific subgroup analysis

“…In gerontology, during the past 2 decades, older adults have often been subdivided into three categories: young‐old (65–74 years old), old‐old (75–84 years old) and oldest‐old (≥85 years old; Crews & Zavotka, 2006). Previous studies have shown specific differences in general and clinical characteristics in age‐specific groups (Koo et al, 2017; Salive, 2013; Yang et al, 2019). In addition, not only did the factors affecting or related to each health outcome differ, the effect of intervention was also different in age‐specific groups (Cho et al, 2017; Noh et al, 2021).…”

Healthcare needs in elderly patients with chronic heart failure in view of a personalized blended collaborative care intervention: a cross sectional study

“…Elderly patients with HF represent a vulnerable group with a wide range of somatic and mental comorbidities ( 3 , 4 ) leading to low health related quality of life ( 5 ). This complicated clinical picture may result in complex drug-to-drug interactions due to polypharmacy ( 6 – 8 ), poor medical adherence ( 6 ) and increased hospitalizations and mortality rates ( 8 , 9 ). All of these factors contribute to a higher dependency in self-care and daily activities ( 10 ).…”