TAVR in Older Adults: Moving Toward a Comprehensive Geriatric Assessment and Away From Chronological Age: JACC Family Series

Abdulla A. Damluji, Gwen Bernacki, Jonathan Afilalo, Radmila Lyubarova, Ariela R. Orkaby, Min Ji Kwak, Scott Hummel, James N. Kirkpatrick, Mathew S. Maurer, Nanette Wenger, Michael W. Rich, Dae Hyun Kim, Roberta Y. Wang, Daniel E. Forman, Ashok Krishnaswami

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations

Abstract

Calcific aortic stenosis can be considered a model for geriatric cardiovascular conditions due to a confluence of factors. The remarkable technological development of transcatheter aortic valve replacement was studied initially on older adult populations with prohibitive or high-risk for surgical valve replacement. Through these trials, the cardiovascular community has recognized that stratification of these chronologically older adults can be improved incrementally by invoking the concept of frailty and other geriatric risks. Given the complexity of the aging process, stratification by chronological age should only be the initial step but is no longer sufficient to optimally quantify cardiovascular and noncardiovascular risk. In this review, we employ a geriatric cardiology lens to focus on the diagnosis and the comprehensive management of aortic stenosis in older adults to enhance shared decision-making with patients and their families and optimize patient-centered outcomes. Finally, we highlight knowledge gaps that are critical for future areas of study.

Original languageEnglish
Article number100877
JournalJACC: Advances
Volume3
Issue number4
DOIs
StatePublished - Apr 2024

Keywords

  • TAVR
  • aging
  • biological age
  • calcific aortic stenosis
  • chronological age
  • cognitive function
  • frailty
  • patient-centered outcomes
  • physical function
  • physiological age
  • quality of life

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