Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.
Saint Luke's Mid America Heart Institute, University of Missouri, Kansas City, MO.
Mayo Clin Proc. 2020 Jun;95(6):1231-1252. doi: 10.1016/j.mayocp.2019.09.003.
Cardiovascular disease (CVD) disproportionately affects older adults. It is expected that by 2030, one in five people in the United States will be older than 65 years. Individuals with CVD now live longer due, in part, to current prevention and treatment approaches. Addressing the needs of older individuals requires inclusion and assessment of frailty, multimorbidity, depression, quality of life, and cognition. Despite the conceptual relevance and prognostic importance of these factors, they are seldom formally evaluated in clinical practice. Further, although these constructs coexist with traditional cardiovascular risk factors, their exact prevalence and prognostic impact remain largely unknown. Development of the right decision tools, which include these variables, can facilitate patient-centered care for older adults. These gaps in knowledge hinder optimal care use and underscore the need to rigorously evaluate the optimal constructs for providing care to older adults. In this review, we describe available tools to examine the prognostic role of age-related factors in patients with CVD.
心血管疾病（CVD）在老年人中发病率较高。预计到 2030 年，美国每五个人中就有一个人年龄超过 65 岁。由于目前的预防和治疗方法，患有 CVD 的人现在的寿命更长。为满足老年人的需求，需要关注虚弱、多种疾病并存、抑郁、生活质量和认知等问题。尽管这些因素在概念上具有相关性且对预后具有重要意义，但在临床实践中很少对其进行正式评估。此外，尽管这些结构与传统心血管危险因素共存，但它们的确切患病率和预后影响在很大程度上仍不清楚。开发包含这些变量的正确决策工具可以促进为老年人提供以患者为中心的护理。这些知识上的差距阻碍了最佳护理的使用，强调了需要严格评估为老年人提供护理的最佳结构。在这篇综述中，我们描述了现有的工具，用于检查与年龄相关的因素在 CVD 患者中的预后作用。
