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Interventions for Frailty Among Older Adults With Cardiovascular Disease
Open accessAbstract
With the aging of the world's population, a large proportion of patients seen in cardiovascular practice are older adults, but many patients also exhibit signs of physical frailty. Cardiovascular disease and frailty are interdependent and have the same physiological underpinning that predisposes to the progression of both disease processes. Frailty can be defined as a phenomenon of increased vulnerability to stressors due to decreased physiological reserves in older patients and thus leads to poor clinical outcomes after cardiovascular insults. There are various pathophysiologic mechanisms for the development of frailty: cognitive decline, physical inactivity, poor nutrition, and lack of social supports; these risk factors provide opportunity for various types of interventions that aim to prevent, improve, or reverse the development of frailty syndrome in the context of cardiovascular disease. There is no compelling study demonstrating a successful intervention to improve a global measure of frailty. Emerging data from patients admitted with heart failure indicate that interventions associated with positive outcomes on frailty and physical function are multidimensional and include tailored cardiac rehabilitation. Contemporary cardiovascular practice should actively identify patients with physical frailty who could benefit from frailty interventions and aim to deliver these therapies in a patient-centered model to optimize quality of life, particularly after cardiovascular interventions.
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“Malnutrition, cachexia, sarcopenia, and frailty are phenotypically distinct but interconnected conditions with interrelated pathophysiological processes that lead to different magnitudes of wasting and susceptibility to adverse outcomes.81–83”
From Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association (2026) · cites this paper as [83]
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Frailty and Cardiovascular Risk
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Cardiovascular-kidney-metabolic syndrome in an ageing population: what does frailty add?
Troy, A. L., Ndumele, C. E., & Dodson, J. A. (2026) · European Journal of Preventive Cardiology · doi:10.1093/eurjpc/zwag244 · Cited by 1
KOMONSKI, A., JOUANNEAU, K., Boureau, A., & Huet, J. (2026) · Journal of Rehabilitation Medicine · doi:10.2340/jrm.v58.45667 · Cited by 1
Fumagalli, S., Biagioli, M., Niccolini, M., Tariello, A., Berni, E., Davino, D., Angelis, V. D., Santamaria, E., Mengozzi, A., Serio, C. D., et al. (2026) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2026.107023 · Cited by 1
Gan, S., Seo, E. J., Rhee, S. Y., Seo, W., Kim, W. J., Park, H. A., Park, R. W., & Bae, S. H. (2026) · European Journal of Cardiovascular Nursing · doi:10.1093/eurjcn/zvag162 · Cited by 1
Covo, D. A. P., Bueno, C. O. P., Gómez, D. A. O., Urrego, S. R., Henao, A. S. T., Abello, A. F. C., Arbelaez-Hoyos, C., Gil, F., Castro-Paris, R., Cáceres-Méndez, E. A., et al. (2026) · Clinical Medicine Insights Cardiology · doi:10.1177/11795468261475707 · Cited by 1
Ikenaga, H., & Nakano, Y. (2023) · Circulation Journal · doi:10.1253/circj.cj-23-0014 · Cited by 1
Feasibility of frailty screening among patients with advanced heart failure
Lehto, H., Jain, N., Bernacki, R., Landzberg, M. J., Desai, A. S., & Orkaby, A. R. (2023) · BMJ Open Quality · doi:10.1136/bmjoq-2023-002430 · Cited by 1
Vegas, C. D. P., Sánchez, D. Z., García, A. S., López‐Izquierdo, R., Belloso, S. S., Pérez-Oleaga, C. M., Azpíroz, I. D., Elío, I., & Rodríguez, F. M. (2023) · BMJ Open · doi:10.1136/bmjopen-2023-078815 · Cited by 1
Nishijima, C., Katayama, O., Lee, S., Makino, K., Harada, K., Morikawa, M., Tomida, K., Yamaguchi, R., Fujii, K., Misu, Y., et al. (2024) · Scientific Reports · doi:10.1038/s41598-024-55301-4 · Cited by 1
Frailty and Cognitive Function in Aging Adults With Congenital Heart Disease
Carazo, M. (2024) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2024.02.006 · Cited by 1
Association between Gardening Activity and Frailty in Patients with Heart Failure
Saito, M., Kinoshita, M., Sumimoto, T., Tasaka, T., Nakagawa, H., Fujimoto, K., Sato, S., Fujisawa, Y., Nishimura, K., Miyake, Y., et al. (2024) · Internal Medicine · doi:10.2169/internalmedicine.3628-24 · Cited by 1
“Lastly, no studies have evaluated the efficacy of gardening activities, specifically in patients with HF. Patients with HF often exhibit frailty, thus making prevention crucial in disease management (29, 30).”
Prognostic Impact of Being Underweight in Patients Undergoing Mitral TEER: The OCEAN-Mitral Registry
Higuchi, R., Izumo, M., Izumi, Y., Saji, M., Isobe, M., Akashi, Y. J., Yamamoto, M., Asami, M., Enta, Y., Nakashima, M., et al. (2024) · ESC Heart Failure · doi:10.1002/ehf2.15047 · Cited by 1
“24 Even though the affected stress is similar among the underweight and other groups, underweight patients are more susceptible, which may lead to the highest rate of non-home discharge.”
Li, Y., Shen, X., Chen, C., Zhong, P., Su, B., & Zheng, X. (2025) · Journal of Hazardous Materials Advances · doi:10.1016/j.hazadv.2024.100585 · Cited by 1
Preoperative Telerehabilitation Improves Outcomes After Cardiac Surgery
Verma, S., Mori, M., & Gaudino, M. F. L. (2025) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2024.11.031 · Cited by 1
Research Advances and Clinical Implications of Atherosclerotic Cardiovascular Diseases and Frailty
陈, 偲. (2025) · Advances in Clinical Medicine · doi:10.12677/acm.2025.151130 · Cited by 1
Is Frailty the Geriatric Troponin?
McMillan, J. M., & Falutz, J. (2025) · Journal of the American Geriatrics Society · doi:10.1111/jgs.19423 · Cited by 1
“Frailty assessment is integrated into the assessment of candidate patients for transthoracic aortic valvuloplasty, candidates for liver transplantation, and persons over 65 with malignancies [6–8].”
Frailty and hospital outcomes among patients with neurological disorders
Blasi, M. T., Raffaele, F., Belvisi, D., Buscarnera, S., Bruno, G., Fabbrini, G., & Canevelli, M. (2025) · Neurological Sciences · doi:10.1007/s10072-025-08144-4 · Cited by 1
Frailty changes after cardiac surgery: better or worse?
Teng, C., Chen, S., Wei, Y., Hsu, R., Chi, N.-H., Wang, S., Chen, Y., & Chen, C. (2025) · European Journal of Cardiovascular Nursing · doi:10.1093/eurjcn/zvaf089 · Cited by 1
Mao, B., Fang, X., & Liu, L. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1602953 · Cited by 1
Incorporating Implementation Science Into Frailty Interventions for Cardiovascular Disease
Teow, K. H., Wong, J. J., Zhao, Y., Wang, L. Y., Choo, S., & Koh, A. S.-M. (2025) · JACC Advances · doi:10.1016/j.jacadv.2025.102278 · Cited by 1
Bridging Frailty and PCI-Related Myocardial Infarction in Cardiovascular Care
Sarraf, M., & Nagaraja, V. (2025) · Heart Lung and Circulation · doi:10.1016/j.hlc.2025.02.098 · Cited by 1
Damluji, A. A., Chen, V., & Nanna, M. G. (2025) · JACC Advances · doi:10.1016/j.jacadv.2025.102273 · Cited by 1
Self-citationFrailty in Cardiovascular Disease
Damluji, A. A., Nanna, M. G., & Menon, V. (2025) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2025.10.046 · Cited by 1
Self-citationPercutaneous Coronary Intervention in Heart Failure: Knowledge Gaps and Opportunities
Tehrani, B. N., Damluji, A. A., & Batchelor, W. (2022) · Journal of the Society for Cardiovascular Angiography & Interventions · doi:10.1016/j.jscai.2022.100032
“13 While a number of tools have been developed to risk stratify older frail patients with cardiovascular disease, many were intended for use in the outpatient setting and not speci fi cally for PCI.”
BackgroundSelf-citationFrailty als Herausforderung im klinischen Alltag
Schönenberger, E., Mörgeli, R., & Borchers, F. (2022) · AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie · doi:10.1055/a-1760-8270
“Die Prävalenz für kardiovaskuläre Erkrankungen ist mit 75% für die 60- bis 79-jährigen Patienten hoch und erhöht sich weiter mit zunehmendem Alter [35].”
BackgroundPrototype sensor system for analyzing frailty in older people: a pilot study
Mello, J. L. D. C., Veiga, D. F., Galhardo, V. Â. C., Ferreira, L. M., Tamaki, C. M., Ramos, A. C. B., & de Souza, D. M. S. T. (2023) · Research Society and Development · doi:10.33448/rsd-v12i3.40649
Ijaz, N. (2023) · JACC Advances · doi:10.1016/j.jacadv.2023.100436
Self-citationImpact of Frailty on Left Ventricular Assist Device Clinical Outcomes
Imburgio, S., Udongwo, N., Mararenko, A., Johal, A. S., TAFA, M., Akhlaq, H., Dandu, S., Hossain, M., Alshami, A., Sealove, B. A., et al. (2023) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2023.08.171
吴, 国. (2023) · Advances in Clinical Medicine · doi:10.12677/acm.2023.13102278
Gleva, M. J., & Maddox, K. E. J. (2024) · Heart Rhythm O2 · doi:10.1016/j.hroo.2024.01.003
Metadata
- Authors
- Ijaz, N., Buta, B., Xue, Q.-L., Mohess, D. T., Bushan, A., Tran, H., Batchelor, W., deFilippi, C. R., Walston, J. D., Bandeen-Roche, K., Forman, D. E., Resar, J. R., O’Connor, C. M., Gerstenblith, G., & Damluji, A. A.
- Affiliations
- Inova Health System (US)
- Johns Hopkins University (US)
- University of Pittsburgh (US)
- Corresponding author
- Damluji, Abdulla A.
- ORCID
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2022-02
- Volume
- 79
- Issue
- 5
- Pages
- 482-503
- ISSN
- 0735-1097 (ISSN-L)
- PMC
- PMC8852369
- OpenAlex
- W4210642841
- Cited by
- 412
- References
- 112
- Citations by year
- 2026: 87 · 2025: 126 · 2024: 105 · 2023: 66 · 2022: 28
- FWCI
- 11.62
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (P30AG021334)
- National Heart, Lung, and Blood Institute (K23HL153771)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- frailty, older adults, cardiovascular disease, frailty interventions, heart failure, cardiac rehabilitation, physical function, cognitive decline, physical inactivity, nutrition, social support, frailty prevention, quality of life
- MeSH terms
- Cardiac Rehabilitation, Frailty, Aged, Aging, Cardiovascular Diseases, Humans, Quality of Life, Risk Factors, Frail Elderly
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