A 4-domain framework addressing physical functioning, social, psychological, and behavioral dimensions can improve health outcomes for older adults with heart failure.
A 4-domain framework is proposed to address the multidimensional needs of older adults with heart failure, incorporating physical, social, psychological, and behavioral dimensions.
Heart failure (HF) is a quintessential geriatric cardiovascular condition, with more than 50% of hospitalizations occurring in adults age 75 years or older. In older patients, HF is closely linked to processes inherent to aging, which include cellular and structural changes to the myocardium, vasculature, and skeletal muscle. In addition, HF cannot be considered in isolation of physical functioning, or without the social, psychological, and behavioral dimensions of illness. The role of frailty, depression, cognitive impairment, nutrition, and goals of care are each uniquely relevant to the implementation and success of medical therapy. In this paper, we discuss a model of caring for older adults with HF through a 4-domain framework that can address the unique multidimensional needs and vulnerabilities of this population. We believe that clinicians who embrace this approach can improve health outcomes for older adults with HF.
“Simply put, heart failure cannot be considered in isolation, without physical functioning, or the social, psychological, and behavioral dimensions of illness. A four-domain framework – involving medical, mind and emotion, physical function, and social environment – should be incorporated in routine clinical work in a tailored, individualized approach.”
Gorodeski et al. (Mon,) conducted a review in Heart failure in geriatric patients. 4-domain framework was evaluated. A 4-domain framework addressing physical functioning, social, psychological, and behavioral dimensions can improve health outcomes for older adults with heart failure.