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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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“Allied to that, physical frailty is a clinical state with increased susceptibility to stressors due to reduced accounts in multiple physiological systems, resulting in functional decline and increased mortality [3–14].”
Frailty and Cardiovascular Health
James, K., Jamil, Y., Kumar, M., Kwak, M. J., Nanna, M. G., Qazi, S., Troy, A. L., Butt, J. H., Damluji, A. A., Forman, D. E., et al. (2024) · Journal of the American Heart Association · doi:10.1161/jaha.123.031736 · Cited by 151
Self-citation
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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