Frailty and its potential relevance to cardiovascular care

Mandeep Singh, Karen Alexander, Veronique Lee Roger, Charanjit S. Rihal, Heather E. Whitson, Amir Lerman, Arshad Jahangir, K Sreekumaran Nair

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

Frailty is characterized by vulnerability to acute stressors and is a consequence of decline in overall function and physiologic reserves. An estimated 7% of the US population older than 65 years and 30% of octogenarians are frail. The domains to define frailty include mobility, strength, balance, motor processing, cognition, nutrition, endurance, and physical activity. Pathophysiologic pathways leading to frailty involve a multisystem cascade that includes neuroendocrine dysfunction with lower insulinlike growth factor and dehydroepiandrosterone sulfate and an altered inflammatory milieu with increased levels of C-reactive protein, interleukins, tumor necrosis factor α, and abnormal coagulation. Frailty predicts death and heralds the transition to disability in general populations. As the population with coronary artery disease shifts toward older patients, physicians must consider the role of frailty in their patients. This review will enable clinicians to recognize frailty and consider its relevance in their daily practice. We also elaborate on reasons to consider frailty in older adults with cardiovascular disease and focus on its early identification, on referral to specialists, and on care after serious cardiac events.

Original languageEnglish (US)
Pages (from-to)1146-1153
Number of pages8
JournalMayo Clinic Proceedings
Volume83
Issue number10
DOIs
StatePublished - 2008

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Population
Dehydroepiandrosterone Sulfate
Interleukins
C-Reactive Protein
Cognition
Coronary Artery Disease
Intercellular Signaling Peptides and Proteins
Cardiovascular Diseases
Referral and Consultation
Tumor Necrosis Factor-alpha
Exercise
Physicians

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Frailty and its potential relevance to cardiovascular care. / Singh, Mandeep; Alexander, Karen; Roger, Veronique Lee; Rihal, Charanjit S.; Whitson, Heather E.; Lerman, Amir; Jahangir, Arshad; Nair, K Sreekumaran.

In: Mayo Clinic Proceedings, Vol. 83, No. 10, 2008, p. 1146-1153.

Research output: Contribution to journalArticle

Singh, M, Alexander, K, Roger, VL, Rihal, CS, Whitson, HE, Lerman, A, Jahangir, A & Nair, KS 2008, 'Frailty and its potential relevance to cardiovascular care', Mayo Clinic Proceedings, vol. 83, no. 10, pp. 1146-1153. https://doi.org/10.4065/83.10.1146
Singh, Mandeep ; Alexander, Karen ; Roger, Veronique Lee ; Rihal, Charanjit S. ; Whitson, Heather E. ; Lerman, Amir ; Jahangir, Arshad ; Nair, K Sreekumaran. / Frailty and its potential relevance to cardiovascular care. In: Mayo Clinic Proceedings. 2008 ; Vol. 83, No. 10. pp. 1146-1153.
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