Frailty and its potential relevance to cardiovascular care

Mandeep Singh, Karen Alexander, Véronique L. Roger, Charanjit S. Rihal, Heather E. Whitson, Amir Lerman, Arshad Jahangir, K. Sreekumaran Nair

Research output: Contribution to journalReview articlepeer-review

72 Scopus citations


Frailty is characterized by vulnerability to acute stressors and is a consequence of decline in overall function and physiologic reserves. An estimated 7% of the US population older than 65 years and 30% of octogenarians are frail. The domains to define frailty include mobility, strength, balance, motor processing, cognition, nutrition, endurance, and physical activity. Pathophysiologic pathways leading to frailty involve a multisystem cascade that includes neuroendocrine dysfunction with lower insulinlike growth factor and dehydroepiandrosterone sulfate and an altered inflammatory milieu with increased levels of C-reactive protein, interleukins, tumor necrosis factor α, and abnormal coagulation. Frailty predicts death and heralds the transition to disability in general populations. As the population with coronary artery disease shifts toward older patients, physicians must consider the role of frailty in their patients. This review will enable clinicians to recognize frailty and consider its relevance in their daily practice. We also elaborate on reasons to consider frailty in older adults with cardiovascular disease and focus on its early identification, on referral to specialists, and on care after serious cardiac events.

Original languageEnglish (US)
Pages (from-to)1146-1153
Number of pages8
JournalMayo Clinic proceedings
Issue number10
StatePublished - Oct 2008

ASJC Scopus subject areas

  • General Medicine


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