I recently was interviewed by Dr. Thomas Elwood for the NYU Langone Rusk Podcast Series, available here. I’d encourage people to listen to both sessions; Dr. Elwood asked a wide range of detailed questions relating to Geriatric Cardiology both locally and nationally. Here are a few key points:
- Geriatric cardiology is a growing field. Geriatric cardiology has emerged in response to an aging population coupled with advances in cardiovascular therapies. Several programs have been started in the U.S. in the past several years, most combining both patient care and research components.
- Frailty is a strong predictor of adverse outcomes in myocardial infarction. Multiple studies have shown frailty, a state of increased vulnerability to physiologic stressors, to be associated with both immediate consequences (procedure-related complications) and long-term sequelae (recurrent myocardial infarction, mortality). The optimal management of frail myocardial infarction patients remains unclear.
- Older adults are frequently excluded from clinical trials. While this is improving, thanks to the efforts of funding agencies, patient advocates, and the research community, we’re still largely operating in the dark when it comes to applying evidence-based therapies to patients in their 80’s and 90’s.
- Family caregiving is more critical than ever for recovery. As we move towards shorter hospital stays and lower use of skilled nursing facilities, we are asking a lot more of family members than we used to during the early recovery phase. This can lead to both physical and emotional burdens on these caregivers, which the healthcare system is currently under-equipped to address.
- There are multiple barriers to cardiac rehabilitation in older adults. These include transportation, cost, and lack of available facilities. Mobile health (mHealth) strategies may provide a means to increase access, but the efficacy of these programs in older adults remains poorly understood.
By: John Dodson, MD, MPH
aginghearts.org 