Frailty and Cardiovascular Disease

The population is aging, and the biology of aging is conducive to both the development of cardiovascular disease (CVD) as well as frailty, such that a bidirectional relationship exists between the two. Older adults with CVD have a higher prevalence of frailty and those with frailty have a higher prevalence of CVD. An understanding and diagnostic approach to frailty is necessary for cardiovascular providers, as frailty is known to result in more ambiguous and challenging clinical presentations, to impact treatment of CVD, and adversely impact prognosis. Unfortunately, due to variability in frailty definitions and lack of a gold standard frailty assessment, numerous frailty assessments have been created, contributing to confusion and slow uptake to incorporate frailty assessment into the typical cardiovascular assessment. Nevertheless, frailty hugely impacts prognosis across the spectrum of CVD and its presence can allow for interventions to potentially moderate frailty, while also informing shared decision-making and allowing for inherently personalized care, tailored to a patient’s goals. Therefore, a knowledge of frailty is essential to providing top-quality cardiovascular care for the burgeoning population of older adults.