Considerations Regarding Management of Heart Failure in Older Adults

Abstract

Understanding noncardiovascular comorbidities and geriatric syndromes in elderly patients with heart failure (HF) is important as the average age of the population increases. Healthcare professionals need to consider these complex dynamics when managing older adults with HF, especially those older than 80. A number of small studies have described associations between HF and major geriatric domains. With information on patients’ cognitive, functional decline, and ability to adhere to therapy, physicians can plan for individualized treatment goals and recommendations for these patients.

How to Manage Beta-Blockade in Older Heart Failure Patients: A Scoping Review

“…For this reason, treatment efficacy and the optimal management of HF in older patients remains unclear [7,8]. Older HF patients may exhibit age-related conditions, such as frailty, multimorbidity, reduced drug tolerance, and polypharmacy [9][10][11], which may reduce adherence to medical therapies, increase drug-drug interactions, and contribute to worsening HF [11].…”

“…According to the latest guidelines, HF is classified into three types based on the left ventricular ejection fraction (LVEF) [9][10][11][12][13][14], namely HF with reduced ejection fraction (HFrEF), i.e., <41%, HF with mildly reduced ejection fraction (HFmrEF), i.e., with between 41% and 49%, and HF with preserved ejection fraction (HFpEF), i.e., ≥50%. Regarding medical therapy, the current guidelines recommend using four "pillars", regardless of age.…”