Frailty in cardiology: definition, assessment and clinical implications for general cardiology. A consensus document of the Council for Cardiology Practice (CCP), Association for Acute Cardio Vascular Care (ACVC), Association of Cardiovascular Nursing and Allied Professions (ACNAP), European Association of Preventive Cardiology (EAPC), European Heart Rhythm Association (EHRA), Council on Valvular Heart Diseases (VHD), Council on Hypertension (CHT), Council of Cardio-Oncology (CCO), Working Group (WG) Aorta and Peripheral Vascular Diseases, WG e-Cardiology, WG Thrombosis, of the European Society of Cardiology, European Primary Care Cardiology Society (EPCCS)

Author:

Richter Dimitri1,Guasti Luigina2,Walker David3,Lambrinou Ekaterini4,Lionis Christos5,Abreu Ana67,Savelieva Irina8,Fumagalli Stefano9,Bo Mario10,Rocca Bianca11,Jensen Magnus T12,Pierard Luc13,Sudano Isabella14,Aboyans Victor15,Asteggiano Riccardo216

Affiliation:

1. Euroclinic Hospital, Athens, Greece

2. Internal Medicine, Department of Medicine and Surgery, University of Insubria, ASST-settelaghi, Via Guicciardini 5, 21100 Varese, Italy

3. East Sussex Healthcare NHS Trust, Hastings, UK

4. Department of Nursing, School of Health Sciences Cyprus University of Technology Limassol, Limassol, Cyprus

5. Clinic of Social and Family Medicine, School of Medicine, University of Crete, Crete, Greece

6. Cardiology Department, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte, (CHULN) Lisboa, Lisbon, Portugal

7. Centro Académico de Medicina de Lisboa (CAML) and Centro Cardiovascular da Universidade de Lisboa (CCUL), Faculty of Medicine from University of Lisbon (FMUL), Lisbon, Portugal

8. Division of Cardiac and Vascular Sciences, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK

9. Geriatric Intensive Care Unit and Geriatric Arrhythmia Unit, Department of Experimental and Clinical Medicine, University of Florence and AOU Careggi, Largo Brambilla 3, 50134 Florence, Italy

10. Section of Geriatrics, Department of Medical Sciences, University of Turin, Città della Salute e della Scienza, Molinette, Turin, Italy

11. Section of Pharmacology, Department of Safety and Bioethics, Catholic University School of Medicine, Rome, Italy

12. Department of Cardiology, Copenhagen University Hospital Amager & Hvidovre, Kettegaard Alle 30, 2650 Copenhagen, Denmark

13. University of Liège, Liège, Belgium

14. Department of Cardiology, University Heart Center Zurich, University Hospital and University of Zürich, Rämistrasse 100, 8091Zurich, Switzerland

15. Department of Cardiology, Duputren University Hospital, Limoges, France

16. LARC—Laboratorio Analisi e RIcerca Clinica, C.so Venezia 10, 10155 Turin, Italy

Abstract

Abstract Abstract Frailty is a health condition leading to many adverse clinical outcomes. The relationship between frailty and advanced age, multimorbidity and disability has a significant impact on healthcare systems. Frailty increases cardiovascular (CV) morbidity and mortality both in patients with or without known CV disease. Though the recognition of this additional risk factor has become increasingly clinically relevant in CV diseases, uncertainty remains about operative definitions, screening, assessment, and management of frailty. Since the burdens of frailty components and domains may vary in the various CV diseases and clinical settings, the relevance of specific frailty-related aspects may be different. Understanding these issues may allow general cardiologists a clearer focus on frailty in CV diseases and thereby make more tailored clinical decisions and therapeutic choices in outpatients. Guidance on identification and management of frailty are sparse and an international consensus document on frailty in general cardiology is lacking. Moreover, new options linked with eHealth are going to better define and manage frailty. This consensus document on definition, assessment, clinical implications, and management of frailty provides an input to integrate strategies pre- and post-acute CV events with a comprehensive view including out of hospital, office-based diagnostic and therapeutic choices, and based on a multidisciplinary team approach (general cardiologists, nurses, and general practitioners). Keywords Frailty • Frailty in cardiovascular diseases • Multimorbidity • Disability • Frailty domains • Frailty components • Frailty evaluation • Frailty screening • Frailty assessment • Frailty trajectory • Frailty prevention • Frailty management • Rehabilitation • Nutrition • Frailty digital health

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Epidemiology

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