Singh Mandeep, Stewart Ralph, White Harvey
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA
Green Lane Cardiovascular Service, Auckland City Hospital, and University of Auckland, Auckland, New Zealand.
Eur Heart J. 2014 Jul;35(26):1726-31. doi: 10.1093/eurheartj/ehu197. Epub 2014 May 26.
Cardiovascular diseases (CVDs) are the leading cause of morbidity and mortality. With the ageing population, the prognostic determinants among others include frailty, health status, disability, and cognition. These constructs are seldom measured and factored into clinical decision-making or evaluation of the prognosis of these at-risk older adults, especially as it relates to high-risk interventions. Addressing this need effectively requires increased awareness and their recognition by the treating cardiologists, their incorporation into risk prediction models when treating an elderly patient with underlying complex CVD, and timely referral for comprehensive geriatric management. Simple measures such as gait speed, the Fried score, or the Rockwood Clinical Frailty Scale can be used to assess frailty as part of routine care of elderly patients with CVD. This review examines the prevalence and outcomes associated with frailty with special emphasis in patients with CVD.
心血管疾病(CVDs)是发病和死亡的主要原因。随着人口老龄化,预后的决定因素包括虚弱、健康状况、残疾和认知等。这些因素很少被测量,也很少被纳入临床决策或对这些高危老年人预后的评估中,尤其是在涉及高风险干预措施时。有效满足这一需求需要治疗心脏病专家提高认识并认可这些因素,在治疗患有潜在复杂心血管疾病的老年患者时将其纳入风险预测模型,并及时转诊以进行全面的老年病管理。诸如步速、弗里德评分或罗克伍德临床衰弱量表等简单措施可用于评估衰弱,作为心血管疾病老年患者常规护理的一部分。本综述探讨了与衰弱相关的患病率和结局,特别强调了心血管疾病患者。