Skip to main content
SpringerLink
Log in

Introduction: The Specificity of Geriatric Cardiology

  • Chapter
  • First Online:
Cardiac Management in the Frail Elderly Patient and the Oldest Old

  • 670 Accesses

Abstract

Though atherosclerotic vascular and heart disease still represent the first cause of death in western countries, improved primary and secondary prevention of these diseases have given a substantial contribution to the remarkable prolongation of average life expectancy, which over the last two centuries has characterized the demographic transition in Western countries. In Italy, persons over 65 years of age presently represent 21 % of the whole population and will become 33 % in 20 years. The fastest growing segment is represented by individuals 80 years of age and older, whose numbers are expected to more than double over the same time period, while Italian persons over 90 years are now 600.000, while centenarians are more than 17.000, having tripled over the last 15 years.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 99.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Lakatta EG, Levy D. Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises: part II: the aging heart in health: links to heart disease. Circulation. 2003;107:346–54.

    Article  PubMed  Google Scholar 

  2. Rothwell PM, Coull AJ, Silver LE, Fairhead JF, Giles MF, Lovelock CE, Redgrave JN, Bull LM, Welch SJ, Cuthbertson FC, Binney LE, Gutnikov SA, Anslow P, Banning AP, Mant D, Mehta Z, Oxford Vascular Study. Population-based study of event-rate, incidence, case fatality, and mortality for all acute vascular events in all arterial territories (Oxford Vascular Study). Lancet. 2005;366:1773–83.

    Article  CAS  PubMed  Google Scholar 

  3. McLennan SN, Pearson SA, Cameron J, Stewart S. Prognostic importance of cognitive impairment in chronic heart failure patients: does specialist management make a difference? Eur J Heart Fail. 2006;8:494–501.

    Article  PubMed  Google Scholar 

  4. Forman DE, Rich MW, Alexander KP, et al. Cardiac care for older adults: time for a new paradigm. J Am Coll Cardiol. 2011;57:1801–10.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Hazzard WR. I am a geriatrician. J Am Geriatr Soc. 2004;52:161.

    Article  PubMed  Google Scholar 

  6. Cherubini A, Oristrell J, Pla X, Ruggiero C, Ferretti R, Diestre G, Clarfield AM, Crome P, Hertogh C, Lesauskaite V, Prada GI, Szczerbinska K, Topinkova E, Sinclair-Cohen J, Edbrooke D, Mills GH. The persistent exclusion of older patients from ongoing clinical trials regarding heart failure. Arch Intern Med. 2011;171:550–6.

    Article  PubMed  Google Scholar 

  7. Radovanovic D, Seifert B, Urban P, Eberli FR, Rickli H, Bertel O, Puhan MA, Erne P, AMIS Plus Investigators. Validity of Charlson Comorbidity Index in patients hospitalised with acute coronary syndrome. Insights from the nationwide AMIS Plus registry 2002–2012. Heart. 2014;100:288–94.

    Article  PubMed  Google Scholar 

  8. Mosby’s medical dictionary, 9th edition. © 2009, Elsevier http://medical-dictionary.thefreedictionary.com/ageism; Butler RN. A disease called ageism. J Am Geriatr Soc. 1990;38:178–80.

  9. Barquera S, Pedroza-Tobías A, Medina C, Hernández-Barrera L, Bibbins-Domingo K, Lozano R, Moran AE. Global overview of the epidemiology of atherosclerotic cardiovascular disease. Arch Med Res. 2015;46(5):328–38.

    Article  PubMed  Google Scholar 

  10. Wang M, Zhang J, Jiang LQ, Spinetti G, Pintus G, Monticone R, Kolodgie FD, Virmani R, Lakatta EG. Proinflammatory profile within the grossly normal aged human aortic wall. Hypertension. 2007;50:219–27.

    Article  CAS  PubMed  Google Scholar 

  11. Van den Akker M, Buntinx F, Metsemakers JFM, Roos S, Knottnerus JA. Multimorbidity in general practice: prevalence, incidence, and determinants of co-occurring chronic and recurrent diseases. J Clin Epidemiol. 1998;51:367–75.

    Article  PubMed  Google Scholar 

  12. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu C. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351:1296–305.

    Article  CAS  PubMed  Google Scholar 

  13. Bach RG, Cannon CP, Weintraub WS, DiBattiste PM, Demopoulos LA, Anderson HV, DeLucca PT, Mahoney EM, Murphy SA, Braunwald E. The effect of routine, early invasive management on outcome for elderly patients with non-ST-segment elevation acute coronary syndromes. Ann Intern Med. 2004;141:186–95.

    Article  PubMed  Google Scholar 

  14. Di Bari M, Balzi D, Fracchia S, Barchielli A, Orso F, Sori A, Spini S, Carrabba N, Santoro GM, Gensini GF, Marchionni N, Acute Myocardial Infarction in Florence 2 (AMI Florence-2) Working Group. Decreased usage and increased effectiveness of percutaneous coronary intervention in complex older patients with acute coronary syndromes. Heart. 2014;100:1537–42.

    Article  PubMed  Google Scholar 

  15. Balzi D, Barchielli A, Buiatti E, Franceschini C, Lavecchia R, Monami M, Santoro GM, Carrabba N, Margheri M, Olivotto I, Gensini GF, Marchionni N, AMI-Florence Working Group. Effect of comorbidity on coronary reperfusion strategy and long-term mortality after acute myocardial infarction. Am Heart J. 2006;151:1094–100.

    Article  PubMed  Google Scholar 

  16. Balzi D, Barchielli A, Buiatti E, Franceschini C, Mangani I, Del Bianco L, Monami M, Valente S, Gensini GF, Marchionni N, AMI-Florence Working Group. Age and comorbidity in acute myocardial infarction: a report from the AMI-Florence Italian registry. Am J Geriatr Cardiol. 2006;15:35–41.

    Article  PubMed  Google Scholar 

  17. Singer DE, Chang Y, Fang MC, Borowsky LH, Pomernacki NK, Udaltsova N, Go AS. The net clinical benefit of warfarin anticoagulation in atrial fibrillation. Ann Intern Med. 2009;151:297–305.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Dickson VV, Tkacs N, Riegel B. Cognitive influences on self-care decision making in persons with heart failure. Am Heart J. 2007;154:424–31.

    Article  PubMed  Google Scholar 

  19. Vogels RLC, Scheltens P, Schroeder-Tanka JM, Weinstein HC. Cognitive impairment in heart failure: a systematic review of the literature. Eur J Heart Fail. 2007;9:440–9.

    Article  PubMed  Google Scholar 

  20. Debette S, Bauters C, Leys D, Lamblin N, Pasquier F, Groote PD. Prevalence and determinants of cognitive impairment in chronic heart failure patients. Congest Heart Fail. 2007;13:205–8.

    Article  PubMed  Google Scholar 

  21. Dodson JA, Truong TN, Towle VR, Kerins G, Chaudhry SI. Cognitive impairment in older adults with heart failure: prevalence, documentation, and impact on outcomes. Am J Med. 2013;126:120–6.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Millar K, Asbury AJ, Murray GD. Pre-existing cognitive impairment as a factor influencing outcome after cardiac surgery. Br J Anaesth. 2001;86:63–7.

    Article  CAS  PubMed  Google Scholar 

  23. Auais M, Morin S, Nadeau L, Finch L, Mayo N. Changes in frailty-related characteristics of the hip fracture population and their implications for healthcare services: evidence from Quebec, Canada. Osteoporos Int. 2013;24:2713–24.

    Article  CAS  PubMed  Google Scholar 

  24. Afilalo J, Alexander KP, Mack MJ, et al. Frailty assessment in the cardiovascular care of older adults. J Am Coll Cardiol. 2014;63:747–62.

    Article  PubMed  Google Scholar 

  25. Green P, Woglom AE, Genereux P, et al. The impact of frailty status on survival after transcatheter aortic valve replacement in older adults with severe aortic stenosis: a single-center experience. JACC Cardiovasc Interv. 2012;5:974–81.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56:M146–57.

    Article  CAS  PubMed  Google Scholar 

  27. Makkar RR, Fontana GP, Jilaihawi H, Kapadia S, Pichard AD, Douglas PS, Thourani VH, Babaliaros VC, Webb JG, Herrmann HC, Bavaria JE, Kodali S, Brown DL, Bowers B, Dewey TM, Svensson LG, Tuzcu M, Moses JW, Williams MR, Siegel RJ, Akin JJ, Anderson WN, Pocock S, Smith CR, Leon MB. Transcatheter aortic-valve replacement for inoperable severe aortic stenosis. N Engl J Med. 2012;366:1696e1704.

    Article  Google Scholar 

  28. Schoenenberger AW, Stortecky S, Neumann S, Moser A, Jüni P, Carrel T, Huber C, Gandon M, Bischoff S, Schoenenberger CM, Stuck AE, Windecker S, Wenaweser P. Predictors of functional decline in elderly patients undergoing transcatheter aortic valve implantation (TAVI). Eur Heart J. 2013;34:684–92.

    Article  CAS  PubMed  Google Scholar 

  29. Wong CY, Green P, Williams M. Decision-making in transcatheter aortic valve replacement: the impact of frailty in older adults with aortic stenosis. Expert Rev Cardiovasc Ther. 2013;11:761–72.

    Article  CAS  PubMed  Google Scholar 

  30. Leon MB, Smith CR, Mack M, Miller DC, Moses JW, Svensson LG, Tuzcu EM, Webb JG, Fontana GP, Makkar RR, Brown DL, Block PC, Guyton RA, Pichard AD, Bavaria JE, Herrmann HC, Douglas PS, Petersen JL, Akin JJ, Anderson WN, Wang D, Pocock S, PARTNER Trial Investigators. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010;363:1597–607.

    Article  CAS  PubMed  Google Scholar 

  31. Matsuzawa Y, Konishi M, Akiyama E, Suzuki H, Nakayama N, Kiyokuni M, Sumita S, Ebina T, Kosuge M, Hibi K, Tsukahara K, Iwahashi N, Endo M, Maejima N, Saka K, Hashiba K, Okada K, Taguri M, Morita S, Sugiyama S, Ogawa H, Sashika H, Umemura S, Kimura K. Association between gait speed as a measure of frailty and risk of cardiovascular events after myocardial infarction. J Am Coll Cardiol. 2013;61:1964–72.

    Article  PubMed  Google Scholar 

  32. Bell SP, Orr NM, Dodson JA, Rich MW, Wenger NK, Blum K, Harold JG, Tinetti ME, Maurer MS, Forman DE. What to expect from the evolving field of geriatric cardiology. J Am Coll Cardiol. 2015;66:1286–99.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardio-thoracic-vascular Medicine Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

    Niccolò Marchionni (Professor of Geriatrics University of Florence, Director)

  2. Clinica Quisisana, Rome, Italy

    Alessandro Boccanelli

  3. President of Italian Society of Geriatric Cardiology, Rome, Italy

    Alessandro Boccanelli

Authors
  1. Niccolò Marchionni
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alessandro Boccanelli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Niccolò Marchionni .

Editor information

Editors and Affiliations

  1. Hypertension Centre - Syncope Unit, Geriatrics Intensive Care Unit University of Florence and Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

    Andrea Ungar

  2. Professor of Internal Medicine-Geriatrics University of Florence Director, Cardiothoracovascular Department Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

    Niccolò Marchionni

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Marchionni, N., Boccanelli, A. (2017). Introduction: The Specificity of Geriatric Cardiology. In: Ungar, A., Marchionni, N. (eds) Cardiac Management in the Frail Elderly Patient and the Oldest Old. Springer, Cham. https://doi.org/10.1007/978-3-319-43468-1_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-43468-1_1

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43466-7

  • Online ISBN: 978-3-319-43468-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation