Heart Failure Reviews

, Volume 17, Issue 4–5, pp 581–588 | Cite as

Frailty and multiple comorbidities in the elderly patient with heart failure: implications for management

  • Khalil Murad
  • Dalane W. Kitzman


Heart failure (HF) in the elderly is a major public health problem, and its prevalence is rising. Outcomes of HF in the elderly have not changed in the past 2 decades despite the introduction of novel HF therapies. This may be due to the combined impact of multiple comorbidities and frailty. The majority of elderly patients with HF are frail with multiple comorbidities. These comorbidities, along with frailty, contribute to the poor outcome of HF in the elderly and pose independent management challenges. More research is needed to better understand the interaction between frailty and multiple comorbidities and the mechanisms by which they impact HF and its management; develop prognostic tools that incorporate frailty and multiple comorbidities and provide more accurate prediction of outcomes; test available treatments in typical elderly patients; and develop and test novel interventions that directly address the adverse impact of multiple comorbidities and frailty.


Aging Chronic diseases Rehospitalization Outcomes 



The Funding sources N.I.H. 5T32HL087730: Training Grant in Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke and N.I.H. R37AG18915; The Claude D. Pepper Older Americans Independence Center of Wake Forest University N.I.H. P30AG21332.

Conflicts of interest

Khalil Murad, MD: None. Dalane W Kitzman, MD: Served as consultant for and/or received grant support from Synvista (>$10K), Bristol-Meyers-Squibb (>$10K), Novartis (>$10K), Boston Scientific (>$10K), Relypsa (>$10K), Forest Laboratories, and Med.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Department of Epidemiology and Prevention, Division of Public Health SciencesWake Forest University School of MedicineWinston-SalemUSA
  2. 2.Section of General Internal Medicine, Department of Internal MedicineWake Forest University School of MedicineWinston-SalemUSA
  3. 3.Cardiology Section, Department of Internal MedicineWake Forest University School of MedicineWinston-SalemUSA

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