Practical approach on frail older patients attended for acute heart failure

- Frailty is a treatable and potentially reversible syndrome.
- Frailty increases the risk of disability and/or other adverse health outcomes.
- Frailty identification is critical in older patients with acute heart failure.
- The best tool to determine frailty remains to be established.
- Comprehensive Geriatric Assessment is the gold standard instrument for diagnosis of frailty.

Acute heart failure (AHF) is a multi-organ dysfunction syndrome. In addition to known cardiac dysfunction, non-cardiac comorbidity, frailty and disability are independent risk factors of mortality, morbidity, cognitive and functional decline, and risk of institutionalization. Frailty, a treatable and potential reversible syndrome very common in older patients with AHF, increases the risk of disability and other adverse health outcomes. This position paper highlights the need to identify frailty in order to improve prognosis, the risk-benefits of invasive diagnostic and therapeutic procedures, and the definition of older-person-centered and integrated care plans.