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Prioritizing Functional Capacity as a Principal End Point for Therapies Oriented to Older Adults With Cardiovascular Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association.

Abstract：

:Adults are living longer, and cardiovascular disease is endemic in the growing population of older adults who are surviving into old age. Functional capacity is a key metric in this population, both for the perspective it provides on aggregate health and as a vital goal of care. Whereas cardiorespiratory function has long been applied by cardiologists as a measure of function that depended primarily on cardiac physiology, multiple other factors also contribute, usually with increasing bearing as age advances. Comorbidity, inflammation, mitochondrial metabolism, cognition, balance, and sleep are among the constellation of factors that bear on cardiorespiratory function and that become intricately entwined with cardiovascular health in old age. This statement reviews the essential physiology underlying functional capacity on systemic, organ, and cellular levels, as well as critical clinical skills to measure multiple realms of function (eg, aerobic, strength, balance, and even cognition) that are particularly relevant for older patients. Clinical therapeutic perspectives and patient perspectives are enumerated to clarify challenges and opportunities across the caregiving spectrum, including patients who are hospitalized, those managed in routine office settings, and those in skilled nursing facilities. Overall, this scientific statement provides practical recommendations and vital conceptual insights.

journal_name

Circulation

journal_title

Circulation

authors

Forman DE,Arena R,Boxer R,Dolansky MA,Eng JJ,Fleg JL,Haykowsky M,Jahangir A,Kaminsky LA,Kitzman DW,Lewis EF,Myers J,Reeves GR,Shen WK,American Heart Association Council on Clinical Cardiology; Council on Cardiovascular and St

doi

10.1161/CIR.0000000000000483

subject

Has Abstract

pub_date

2017-04-18 00:00:00

pages

e894-e918

issue

eissn

0009-7322

issn

1524-4539

pii

CIR.0000000000000483

journal_volume

135

pub_type

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Prioritizing Functional Capacity as a Principal End Point for Therapies Oriented to Older Adults With Cardiovascular Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association.