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<p>The global population is aging rapidly, creating a growing demand for cardiovascular care that is better aligned with the complex comorbidities and diverse life contexts of older adults. The 5Ms of geriatrics—Mind, Mobility, Medications, Multicomplexity, and What Matters Most—provide a practical framework to individualize treatment strategies based on functional status, comorbidities, and patient values (ikigai). This review explores how integrating the 5Ms into the management of hypertension, atrial fibrillation, and heart failure can guide clinical decision-making in aging societies. We highlight practical strategies, such as deprescribing, fall risk assessment, and shared decision-making, that tailor care to patient priorities. Furthermore, we discuss policy implications, including the need for greater incentives for comprehensive geriatric assessments and advance care planning. Since evidence-based guidelines may not fully capture the complexity of older patients, incorporating the 5Ms and comprehensive assessments can support patient-centered care and help build evidence based on meaningful outcomes in aging societies.</p><p></p>

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Ikigai in aging hearts: Japan’s approach to cardiovascular care

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年10月17日

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  • Ryo Nakamaru,
  • Akitoshi Hara,
  • Yuji Yamada,
  • Mitsuaki Sawano,
  • Koichi Yamamoto

摘要

The global population is aging rapidly, creating a growing demand for cardiovascular care that is better aligned with the complex comorbidities and diverse life contexts of older adults. The 5Ms of geriatrics—Mind, Mobility, Medications, Multicomplexity, and What Matters Most—provide a practical framework to individualize treatment strategies based on functional status, comorbidities, and patient values (ikigai). This review explores how integrating the 5Ms into the management of hypertension, atrial fibrillation, and heart failure can guide clinical decision-making in aging societies. We highlight practical strategies, such as deprescribing, fall risk assessment, and shared decision-making, that tailor care to patient priorities. Furthermore, we discuss policy implications, including the need for greater incentives for comprehensive geriatric assessments and advance care planning. Since evidence-based guidelines may not fully capture the complexity of older patients, incorporating the 5Ms and comprehensive assessments can support patient-centered care and help build evidence based on meaningful outcomes in aging societies.