Harkness Karen, Heckman George A, McKelvie Robert S
Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
Expert Rev Cardiovasc Ther. 2012 Jun;10(6):779-95. doi: 10.1586/erc.12.49.
Managing older heart failure (HF) patients can be complicated by both cardiac and noncardiac conditions. Over the past 20 years, care for HF patients has become more complex, with a rising proportion of older people living with HF. In particular, cognitive impairment (CI) and frailty often coexist with HF in the elderly. With the prevalence of HF, frailty and cognitive impairment rising with age, the simultaneous occurrence of at least two of these conditions in the same individual will become more frequent. The presence of frailty and/or cognitive impairment in older people with HF is independently associated with worse clinical outcomes. The purpose of this review is to provide an overview of frailty and cognitive impairment in older HF patients. Specifically, this article describes the epidemiology of these conditions in HF patients, outlines potential underlying mechanisms, highlights relevant screening tools and reviews relevant clinical implications.
管理老年心力衰竭（HF）患者可能会因心脏和非心脏疾病而变得复杂。在过去20年中，HF患者的护理变得更加复杂，患有HF的老年人比例不断上升。特别是，认知障碍（CI）和虚弱在老年人中常与HF并存。随着HF、虚弱和认知障碍的患病率随年龄增长而上升，这三种情况中至少两种在同一个体中同时出现的情况将变得更加频繁。HF老年患者中存在虚弱和/或认知障碍与更差的临床结局独立相关。本综述的目的是概述老年HF患者的虚弱和认知障碍。具体而言，本文描述了这些情况在HF患者中的流行病学，概述了潜在的潜在机制，突出了相关的筛查工具，并综述了相关的临床意义。
