Fumagalli Carlo, Maurer Mathew S, Fontana Marianna, Fine Nowell, Gillmore Julian, Goyal Parag, Nakagawa Shunichi, Musumeci Beatrice, Grogan Martha, Marfella Raffaele, Limongelli Giuseppe, Bo Mario, Longhi Simone, Cuddy Sarah, Masri Ahmad, Olivotto Iacopo, Perfetto Federico, Ungar Andrea, Marchionni Niccolò, Cappelli Francesco
Tuscan Regional Amyloidosis Centre, Careggi University Hospital, Florence, Italy.
Department of Advanced Medical and Surgical Sciences, University of Campania-Luigi Vanvitelli, Naples, Italy.
JACC Adv. 2024 Jul 22;3(9):101123. doi: 10.1016/j.jacadv.2024.101123. eCollection 2024 Sep.
Transthyretin cardiac amyloidosis (ATTR-CA) predominantly affects older adults with multiple chronic conditions, leading to significant physical, cognitive, and emotional challenges. New disease-modifying drugs are effective in early stages, prompting a shift toward comprehensive assessments, including functional capacity and quality of life. However, these assessments may not fully capture the complexity of older ATTR-CA patients, especially regarding frailty and mood disorders, which can influence symptom reporting. Thus, integrating comprehensive geriatric assessment tools into routine clinical practice may be crucial to detect early signs of frailty or functional impairment that could impact outcomes and mitigate futility and ageism in the decision-making process. This review highlights the importance of evaluating multimorbidity, disability, and frailty in older patients with ATTR-CA to optimize management strategies.
转甲状腺素蛋白心脏淀粉样变性（ATTR-CA）主要影响患有多种慢性病的老年人，导致重大的身体、认知和情感挑战。新型疾病修饰药物在早期阶段有效，促使人们转向全面评估，包括功能能力和生活质量。然而，这些评估可能无法完全捕捉老年ATTR-CA患者的复杂性，尤其是在虚弱和情绪障碍方面，这可能会影响症状报告。因此，将综合老年评估工具纳入常规临床实践对于检测可能影响治疗结果的虚弱或功能损害的早期迹象，并在决策过程中减少无效治疗和年龄歧视可能至关重要。本综述强调了评估老年ATTR-CA患者的多种疾病、残疾和虚弱以优化管理策略的重要性。
