Heart Failure: The Leading Cause of Hospitalization and Mortality in Older Adults

Though heart failure affects people across different age groups, it is considered the leading cause of hospitalization and mortality among older adults. Experts have pointed out that the prevalence of heart failure tends to increase with increasing age, and additionally, its treatment becomes difficult due to other conditions or issues specific to increasing age. With growing age, cardiovascular diseases, renal functions, and digestive functions of the body tend to slow down in terms of their functional ability. Research indicates that the incidence of heart failure increases nearly 10 to 12 times in individuals aged 80-90 years.

Heart failure can be defined as a medical condition in which the heart is unable to effectively pump blood, leading to an inadequate supply of oxygen and nutrients required by the tissues in the body. It is one of the various heart-related issues affecting individuals. There has been a considerable increase in the prevalence of cardiovascular diseases, with older adults aged 45 and above reporting a prevalence rate of 29.4% for diagnosed cardiovascular diseases (CVDs). This rate increased with age, starting at 22% in the 45–54 age group and reaching 38% in individuals aged 70 and above.

Heart failure is a condition that tends to impact the overall health of an individual, as other functions of the body are affected too. For instance, heart failure can cause damage to the liver or kidneys. An individual suffering from this condition suffers not just physically but also mentally. This is especially true for older adults. Factors leading to heart failure include coronary artery disease, high blood pressure, hypertension, drug or tobacco consumption, kidney diseases, and diabetes.

• Fatigue: Fatigue is a common complaint among the elderly; however, it should not be merely associated with aging. It is often related to low cardiac output and is therefore a major symptom.
• Dyspnea: Dyspnea is a situation where an individual feels a sensation of running out of air. This is an important symptom of heart failure, especially among the elderly.
• Persistent coughing and wheezing: Consistent coughing is often accompanied by pink-tinged phlegm.
• Reduced physical activity: Depending on others, even for the usual physical activities, a reduction in exercise intolerance is a common symptom of heart failure.
• Other symptoms, including confusion, memory deficits, and irritability, are some of the common manifestations of heart failure among the elderly.

Anemia is a condition where the body doesn’t have enough healthy red blood cells to carry oxygen to the tissues of the body. This adds to the growing risk of heart failure.

Non-adherence to the prescribed medication, excessive intake of sodium, lifestyle choices, and side effects of other medications are certain factors that contribute to the progression of the condition.

Heart failure is treated with a combination of lifestyle modifications and medications. However, some patients, especially the older generation, need to undergo additional treatment options, particularly i they have suffered a heart attack before. These options include:

• Left ventricular assist devices (LVADs): A heart transplant is not considered a suitable option for the elderly, especially after 70 years of age. LVADs, on the other hand, are mechanical pumps implanted to enhance blood circulation. LVADs may serve as a long-term solution in such cases where transplantation is not a feasible option. These devices are particularly suitable for those in their 80s.
• Monitoring Fluid/Sodium Intake: Maintaining a healthy diet with a balanced consumption of fluids or sodium can prove beneficial in the treatment of heart failure.
• Psychological support: Extending psychological and emotional support to elderly patients can help improve their overall quality of life.
• Regular Checkups: Regular check-ups help in adjusting the treatment plans based on how responsive the individual is to the treatment process.

With the increasing cases of heart-related diseases, it has become extremely important to understand the causes, symptoms, diagnosis, and treatment options available to treat the conditions. This is especially true for elderly heart failure patients, as with increasing age, diagnosis, and treatment become relatively difficult. This is because various other age-related problems tend to overlap with heart failure, resulting in the neglect of major symptoms or factors contributing to heart failure.