An Aging Nation and the Rise of Geriatric Cardiology

T he aging population presents one of the biggest challenges in cardiovascular medicine.In the United States, there are 23 million people over the age of 75 years, and this group will continue to increase in number. 1 Not only does this aging demographic contribute to a growing burden of cardiovascular diseases in the population overall, but it poses unique challenges for the medical community.Care of the older adult is becoming increasingly complex due, in part, to multiple medical comorbidities.Twenty-five percent of adults over the age of 85 years have more than 6 chronic medical conditions. 2 Other considerations include concurrent geriatric syndromes that overlap with cardiac disease, including frailty, polypharmacy, or abnormalities in cognition and physical function.When medical treatment is required, there is less data-driven guidance because older adults have often been excluded from large clinical trials.Clinical practice guidelines do not specifically address older adults, even for common conditions such as heart failure, 3 arrhythmias, 4,5 valve disease, 6,7 and coronary artery disease, 8 and therefore, management often relies on individual clinician judgment.This is also important because health priorities for older adults frequently differ compared with a younger population: Many older adults may prioritize function and quality of life over longevity.