Optimizing Cardiovascular Care in Aging Populations: A Comprehensive Review of Geriatric Cardiology

Abstract

A narrative review was conducted by searching recent literature in databases like Cochrane and PubMed, using keywords such as "older adults", "cardiovascular disease", "frailty", and "polypharmacy". The identified literature included cohort studies, scientific statements, systematic reviews, meta-analyses, and narrative reviews from the last 15 years focusing on comprehensive care and recent evidence-based updates in geriatric cardiology. Inclusion criteria of the aging population and the elderly with cardiovascular conditions have been applied. The review excluded articles on pregnant women and children, studies on animals, and articles not written in English. A thematic synthesis was conducted to identify key challenges and strategies in geriatric cardiovascular care, focusing on multimorbidity, cognitive impairment, and integrative care models. Our narrative review documents definitions, findings, recent updates and practical approaches that can be implemented in geriatric practice addressing diagnostic and therapeutic challenges in geriatric cardiology; disadvantages of traditional-disease focused models in elderly; frailty, multimorbidity, polypharmacy and overcoming them; health inequities and disparities in cardiogeriatric populations; and finally about some of the areas needing future researches and policies. The global rise in the aging population has contributed to cardiovascular diseases (CVDs) becoming a dominant health concern among older adults who often present with a range of coexisting conditions. These geriatric syndromes complicate standard cardiovascular care, making collaborative multidisciplinary and patient-centered strategies essential to improve health outcomes and functional independence. This narrative review is aimed at exploring the efficacy of integrated, evidence-based multidisciplinary cardiovascular care models on improving clinical outcomes and quality of life (QoL) among geriatric adults. The objective evaluates and compares the impact of these models versus traditional practices, while also exploring key challenges and recent innovations in cardiovascular care for aging populations.

Keywords: comprehensive geriatric assessment; geriatric cardiology; multidisciplinary treatments; multimorbidity management; polypharmacy.

Figure 1. Prevalence of frailty, multimorbidity, and cognitive impairment in geriatric patients with cardiovascular diseases, signifying that they are interconnected

Data adapted from [5,14,23] to create an image. Image credit: Shreya Agarwal

Figure 2. Figure demonstrating how different multimorbidities have similar symptoms to those of heart failure, leading to a delay in diagnosis or misdiagnosis

Image credit: Shreya Agarwal

Figure 3. Image comparing the effectiveness of comprehensive geriatric assessment with that of the traditional disease-focused approach

Image credit: Siri Chithanuru

Figure 4. Roles of different healthcare workers in a multidisciplinary approach

Image credit: Shreya Agarwal

Figure 5. Various barriers faced by the minorities and the LGBTQ+ communities in each step from onset to symptoms to long-term management

Image credit: Shreya Agarwal

Figure 6. Image explaining how cardiovascular diseases in the elderly can be prevented at separate levels

Image credit: Shreya Agarwal