This ACC Scientific Statement reviews the intersections among cardiovascular disease (CVD), cognitive impairment, and frailty in older adults, including shared biological aging mechanisms (vascular dysfunction, chronic inflammation, sarcopenia) and consensus-based approaches for prevention, assessment, and management.
Key recommendations include treating CVD, cognitive impairment, and frailty as manifestations of shared biological aging; targeting common modifiable risk factors; ensuring appropriate diagnostic evaluation and referral; and promoting resilience through structured exercise, nutrition, medications, and reducing polypharmacy.
Authors acknowledge recommendations rest on a 'limited and fragmented evidence base'; the statement is consensus-based rather than derived from dedicated clinical trials in this population.
Cardiologists caring for older adults should routinely screen for cognitive impairment and frailty, as these conditions share biological roots with CVD and directly affect treatment decisions. Structured exercise, nutrition optimization, and polypharmacy reduction should be integrated into cardiovascular care plans for this population.
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