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J Am Coll Cardiol. 2018 May 15;71(19):2149-2161. doi: 10.1016/j.jacc.2018.03.022.

Multimorbidity in Older Adults With Cardiovascular Disease.

Author information

1
Department of Medicine, Section of Geriatric Cardiology, Veterans Affairs Geriatric Research Education, and Clinical Center, University of Pittsburgh, Pittsburgh, Pennsylvania. Electronic address: formand@pitt.edu.
2
Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York.
3
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
4
Phillip R. Lee Institute for Health Policy Studies, University of California-San Francisco, San Francisco, California.
5
Division of Geriatrics and Clinical Gerontology, National Institute on Aging, Bethesda, Maryland.
6
Association of Specialty Professors, Alexandria, Virginia.
7
Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
8
John A. Hartford Foundation, New York, New York.
9
Division of Geriatrics, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California.
10
Division of Cardiology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.

Abstract

Multimorbidity occurs in adults of all ages, but the number and complexity of comorbid conditions commonly increase with advancing age such that cardiovascular disease (CVD) in older adults typically occurs in a context of multimorbidity. Current clinical practice and research mainly target single disease-specific care that does not embrace the complexities imposed by concurrent conditions. In this paper, emerging concepts regarding CVD in combination with multimorbidity are reviewed, including recommendations for incorporating multimorbidity into clinical decision making, critical knowledge gaps, and research priorities to optimize care of complex older patients.

KEYWORDS:

aging; frailty; multimorbidity; polypharmacy; quality of life

PMID:
29747836
DOI:
10.1016/j.jacc.2018.03.022

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