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老年心脏病学:走向成熟。

Geriatric Cardiology: Coming of Age.

作者信息

Goyal Parag, Kwak Min Ji, Al Malouf Christina, Kumar Manish, Rohant Namit, Damluji Abdulla A, Denfeld Quin E, Bircher Kim K, Krishnaswami Ashok, Alexander Karen P, Forman Daniel E, Rich Michael W, Wenger Nanette K, Kirkpatrick James N, Fleg Jerome L

机构信息

Department of Medicine, Weill Cornell Medicine, New York, New York, USA.

Division of Geriatric and Palliative Medicine, McGovern Medical School, Houston, Texas, USA.

出版信息

JACC Adv. 2022 Aug;1(3). doi: 10.1016/j.jacadv.2022.100070. Epub 2022 Aug 26.

Abstract

Older adults with cardiovascular disease (CVD) contend with deficits across multiple domains of health due to age-related physiological changes and the impact of CVD. Multimorbidity, polypharmacy, cognitive changes, and diminished functional capacity, along with changes in the social environment, result in complexity that makes provision of CVD care to older adults challenging. In this review, we first describe the history of geriatric cardiology, an orientation that acknowledges the unique needs of older adults with CVD. Then, we introduce 5 essential principles for meeting the needs of older adults with CVD: 1) recognize and consider the potential impact of multicomplexity; 2) evaluate and integrate constructs of cognition into decision-making; 3) evaluate and integrate physical function into decision-making; 4) incorporate social environmental factors into management decisions; and 5) elicit patient priorities and health goals and align with care plan. Finally, we review future steps to maximize care provision to this growing population.

摘要

患有心血管疾病(CVD)的老年人由于与年龄相关的生理变化以及CVD的影响,在多个健康领域面临缺陷。多种疾病共存、多种药物治疗、认知变化、功能能力下降,以及社会环境的变化,导致情况复杂,使得为老年人提供CVD护理具有挑战性。在本综述中,我们首先描述老年心脏病学的历史,这是一种承认患有CVD的老年人独特需求的取向。然后,我们介绍满足患有CVD的老年人需求的5项基本原则:1)认识并考虑多重复杂性的潜在影响;2)在决策中评估并整合认知结构;3)在决策中评估并整合身体功能;4)将社会环境因素纳入管理决策;5)引出患者的优先事项和健康目标并使其与护理计划保持一致。最后,我们回顾为这一不断增长的人群提供最大化护理的未来步骤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0332/11202959/1d0284f3f187/fx1.jpg

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