Frailty – management difficulties in elderlies with cardiovascular disease

Introduction: Frailty represents a complex clinical syndrome of increased vulnerability to stressors whi-ch results from multiple impairments across different systems, and accounts, at least in part, for the hetero-geneity between biological and chronological age. A clinically useful definition of frailty includes slowness, weakness, low physical activity, exhaustion, and weight loss. Improved life expectation in developed countries determines the population ageing, so the age-related conditions regarding elderly become a serious problem.
The prevalence of cardiovascular disease and the rate of cardiovascular mortality in elderly are increasing. The comorbid conditions, frailty, and general health status as well as cardiovascular disease are responsible for high rate of mortality in elderly.
Methods: A number of simple tools are available to measure frailty using some or all of the key frailty criteria—by questionnaires or simple measurements, like gait speed over 5-10 meters, chair rises, balance, the Fried scale, based on the presence or absence slowness assessed by walk speed, weakness assessed by hand grip strength, and self-reported low physical activity, exhaustion, and unintentional weight loss, and the simple FRIAL Questionnaire Screening Tool.
Results: Frail patients with cardiovascular disease have a worse prognosis than non-frail patients. Frailty is a dynamic condition and its early stages are potentially reversible. The interventions recommended to reduce frailty are exercise-based rehabilitation, dietary counseling, vitamin D supplements to improve muscle function, reduce falls and fractures and avoiding polypharmacy.
Conclusions: Identifying frailty is important because it is associated with an increased risk of both cardiovas-cular and non-cardiovascular morbidity and mortality, dependency, and complications.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)
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