Consensus document on frailty in cardiology
A high number of groups (among these the European Primary Care Cardiology Society [EPCCS]) have joined and generated a consensus document on the definition, assessment, clinical implications and management of frailty to help integrate strategies before and after acute CV events. This comprehensive view includes out of hospital, office-based diagnostic and therapeutic choices and is based on a multidisciplinary team approach of cardiologists, nurses and general practitioners.
Frailty is characterized by a reduced physiologic reserve and ability to maintain homeostasis resulting in higher vulnerability to stressors and increased risk of adverse outcomes. Frailty increases CV morbidity and mortality in patients with or without CVD and is increasingly recognized as clinically relevant in CVD. In general, it is getting more attention due to population ageing, the implications for clinical practice, the opportunity to slow down an accelerated clinical decline, and the impact on healthcare systems. But there are uncertainties about definitions, screening, assessment and management of frailty. Also the burden of frailty components may be different in types of CVD and settings. There is therefore a need for guidance on identification and management of frailty in order for cardiologists to make more tailored clinical decisions and therapeutic choices in outpatients.