Multimorbidity in Older Adults with Heart Failure.
Multimorbidity is common among older adults with heart failure and creates diagnostic and management challenges. Diagnosis of heart failure may be difficult, as many conditions commonly found in older persons produce dyspnea, exercise intolerance, fatigue, and weakness; no singular pathognomonic finding or diagnostic test differentiates them from one another. Treatment may also be complicated, as multimorbidity creates high potential for drug-disease and drug-drug interactions in settings of polypharmacy. The authors suggest that management of multimorbid older persons with heart failure be patient, rather than disease-focused, to best meet patients' unique health goals and minimize risk from excessive or poorly-coordinated treatments.
Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, 1 Church Street, Suite 200, New Haven, CT 06510, USA; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, 1 Church Street, Suite 200, New Haven, CT 06510, USA. Electronic address: kumar.dharmarajan@yale.edu.
Kumar
K
Dharmarajan
Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA; Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
Shannon M
SM
Dunlay
D000368:Aged; D015897:Comorbidity; D055317:Evidence-Based Practice / Q000379:methods / Q000458:organization & administration; D006333:Heart Failure / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D000069342:Medical Overuse / Q000517:prevention & control*; D018802:Patient-Centered Care / Q000379:methods / Q000458:organization & administration
Cognitive impairment; Geriatrics; Health outcomes; Heart failure; Multimorbidity; Multiple chronic conditions; Polypharmacy; Quality of care