Author + information
- Received November 28, 2017
- Revision received February 22, 2018
- Accepted February 25, 2018
- Published online April 23, 2018.
- Eiran Z. Gorodeski, MD, MPHa,∗∗ (, )
- Parag Goyal, MD, MScb,∗,
- Scott L. Hummel, MDc,d,
- Ashok Krishnaswami, MD, MASe,
- Sarah J. Goodlin, MDf,g,
- Linda L. Hart, DNP, ACNPh,
- Daniel E. Forman, MDi,j,k,
- Nanette K. Wenger, MDl,
- James N. Kirkpatrick, MDm,
- Karen P. Alexander, MDn,
- on behalf of the Geriatric Cardiology Section Leadership Council, American College of Cardiology
- aDepartment of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
- bDivision of Cardiology and Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York
- cDivision of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
- dAnn Arbor Veterans Affairs Health System, Ann Arbor, Michigan
- eDivision of Cardiology, Kaiser Permanente San Jose Medical Center, San Jose, California
- fGeriatrics Section, Veterans Affairs Portland Health Care System, Portland, Oregon
- gDepartment of Medicine, Oregon Health & Sciences University, Portland, Oregon
- hBon Secours Heart and Vascular Institute, Richmond, Virginia
- iSection of Geriatric Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
- jGeriatric Research Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare Center, Pittsburgh, Pennsylvania
- kUniversity of Pittsburgh, Pittsburgh, Pennsylvania
- lDivision of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
- mCardiovascular Division, Department of Medicine, Department of Bioethics and Humanities, University of Washington Medical Center, Seattle, Washington
- nDivision of Cardiology, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
- ↵∗Address for correspondence:
Dr. Eiran Z. Gorodeski, Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Desk J3-4, 9500 Euclid Avenue, Cleveland, Ohio 44195.
Heart failure (HF) is a quintessential geriatric cardiovascular condition, with more than 50% of hospitalizations occurring in adults age 75 years or older. In older patients, HF is closely linked to processes inherent to aging, which include cellular and structural changes to the myocardium, vasculature, and skeletal muscle. In addition, HF cannot be considered in isolation of physical functioning, or without the social, psychological, and behavioral dimensions of illness. The role of frailty, depression, cognitive impairment, nutrition, and goals of care are each uniquely relevant to the implementation and success of medical therapy. In this paper, we discuss a model of caring for older adults with HF through a 4-domain framework that can address the unique multidimensional needs and vulnerabilities of this population. We believe that clinicians who embrace this approach can improve health outcomes for older adults with HF.
↵∗ Drs. Gorodeski and Goyal contributed equally to this work and are joint first authors.
The views expressed in this paper by the American College of Cardiology's (ACC's) Geriatric Cardiology Member Section Council do not necessarily reflect the views of the Journal of the American College of Cardiology or the ACC.
Dr. Gorodeski is supported by The Hunnell Fund. Dr. Goyal is supported by National Institute on Aging grant R03AG056446. Dr. Hummel has received research funding from PurFoods, LLC. Dr. Hart has served on the Speakers Bureau of Zoll and Novartis. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received November 28, 2017.
- Revision received February 22, 2018.
- Accepted February 25, 2018.
- 2018 American College of Cardiology Foundation