Older Adults in the Cardiac Intensive Care Unit: Factoring Geriatric Syndromes in the Management, Prognosis, and Process of Care: A Scientific Statement From the American Heart Association

Longevity is increasing, and more adults are living to the stage of life when age-related biological factors determine a higher likelihood of cardiovascular disease in a distinctive context of concurrent geriatric conditions. Older adults with cardiovascular disease are frequently admitted to cardia...

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Vydáno v:Circulation (New York, N.Y.) Ročník 141; číslo 2; s. e6
Hlavní autoři: Damluji, Abdulla A, Forman, Daniel E, van Diepen, Sean, Alexander, Karen P, Page, 2nd, Robert L, Hummel, Scott L, Menon, Venu, Katz, Jason N, Albert, Nancy M, Afilalo, Jonathan, Cohen, Mauricio G
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States 14.01.2020
Témata:
Aged
American Heart Association
Cardiovascular Diseases - pathology
Cardiovascular Diseases - therapy
Decision Making
Delirium - pathology
Disease Management
Energy Intake
Frailty
Geriatric Assessment
Humans
Intensive Care Units
Middle Aged
Multimorbidity
Polypharmacy
Prognosis
Risk Factors
Transitional Care
United States
United States
cognition
aged
multimorbidity
cardiovascular diseases
AHA Scientific Statements
resuscitation orders
frailty
bed rest
decision making
dementia
aging
confusion
delirium
polypharmacy
sarcopenia
ISSN:1524-4539, 1524-4539
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Shrnutí:Longevity is increasing, and more adults are living to the stage of life when age-related biological factors determine a higher likelihood of cardiovascular disease in a distinctive context of concurrent geriatric conditions. Older adults with cardiovascular disease are frequently admitted to cardiac intensive care units (CICUs), where care is commensurate with high age-related cardiovascular disease risks but where the associated geriatric conditions (including multimorbidity, polypharmacy, cognitive decline and delirium, and frailty) may be inadvertently exacerbated and destabilized. The CICU environment of procedures, new medications, sensory overload, sleep deprivation, prolonged bed rest, malnourishment, and sleep is usually inherently disruptive to older patients regardless of the excellence of cardiovascular disease care. Given these fundamental and broad challenges of patient aging, CICU management priorities and associated decision-making are particularly complex and in need of enhancements. In this American Heart Association statement, we examine age-related risks and describe some of the distinctive dynamics pertinent to older adults and emerging opportunities to enhance CICU care. Relevant assessment tools are discussed, as well as the need for additional clinical research to best advance CICU care for the already dominating and still expanding population of older adults.
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ISSN:1524-4539
1524-4539
DOI:10.1161/CIR.0000000000000741