Heart Failure among Older Adults
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.
It is important to take cognizance of the following symptoms of heart failure to establish the diagnosis and the subsequent treatment.
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.
Factors Contributing to Worsening Heart Failure
Anaemia 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: Missing doses or not taking medication as prescribed by the doctor can worsen the condition.
Excessive intake of sodium: A diet high in sodium tends to worsen the symptoms of heart failure as it can lead to fluid retention.
Lifestyle choices: a considerable lack of physical activities, a sedentary lifestyle, smoking, and excessive consumption of alcohol are certain factors that contribute to the progression of the condition.
Side effects of other medications: medicines that an individual might be taking for other health-related issues might have an impact on heart functions. Thus, it can increase the risk of heart failure.
Treating Heart Failure Among Older Adults
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 if 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.
Source:
Heart disease in young Indians: Causes, prevention, and some critical insights by Dr. Ramakanta Panda
