Del Sindaco Donatella, Zuccalà Giuseppe, Pulignano Giovanni, Cocchi Alberto
Unità per lo Scompenso Cardiaco, Dipartimento Cardiogeriatrico, IRCCS INRCA, Roma.
Ital Heart J. 2004 Dec;5 Suppl 10:26S-36S.
Despite recent advances in pharmacotherapy, heart failure represents the major cause of death and hospitalization for elderly people in developed countries. Clinical assessment and management of older patients are often more difficult than in younger ones. Epidemiological studies in geriatrics as well as cardiology setting have demonstrated that elderly heart failure patients are frail and complex individuals, in whom many clinical and non-clinical factors may play a role in determining clinical presentation and prognosis. Thus, management of heart failure in the elderly requires a coordinated, multidimensional and multidisciplinary approach. This article describes the principles of geriatric assessment. Assessment should include the evaluation of comorbidity, cognitive status, functional ability in activities of daily living, psychosocial, environmental and financial factors, and quality of life. Available evidence suggests that geriatric assessment can have a positive effect on patient outcome and overall quality and cost of care.
尽管药物治疗最近取得了进展,但心力衰竭仍是发达国家老年人死亡和住院的主要原因。老年患者的临床评估和管理往往比年轻患者更困难。老年医学以及心脏病学领域的流行病学研究表明,老年心力衰竭患者身体虚弱且情况复杂,许多临床和非临床因素可能在决定临床表现和预后方面发挥作用。因此,老年人心力衰竭的管理需要一种协调、多维度和多学科的方法。本文介绍了老年评估的原则。评估应包括对合并症、认知状态、日常生活活动中的功能能力、心理社会、环境和经济因素以及生活质量的评估。现有证据表明,老年评估可对患者预后以及护理的整体质量和成本产生积极影响。