Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
Division of Cardiology and Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York.
J Am Coll Cardiol. 2018 May 1;71(17):1921-1936. doi: 10.1016/j.jacc.2018.02.059.
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.
心力衰竭（HF）是一种典型的老年心血管疾病，超过 50%的住院患者为 75 岁或以上的成年人。在老年患者中，HF 与衰老过程中固有的过程密切相关，包括心肌、血管和骨骼肌的细胞和结构变化。此外，HF 不能孤立于身体功能来考虑，也不能不考虑疾病的社会、心理和行为方面。虚弱、抑郁、认知障碍、营养和治疗目标的作用对于医疗治疗的实施和成功都具有独特的相关性。在本文中，我们通过一个 4 个领域的框架讨论了一种照顾患有 HF 的老年人的模式，该框架可以解决这一人群独特的多维需求和脆弱性。我们相信，接受这种方法的临床医生可以改善患有 HF 的老年人的健康结果。
