Heart Failure and Frailty (Advanced level)

The incidence of Heart failure increases with age, two thirds of patients are over the age of 75 years at the time of their first admission to hospital with heart failure. Older patients are often multimorbid, have polypharmacy treatment regimens to manage their co-morbidities and have poorer outcomes as a result of their conditions and age. The prevalence of frailty in a heart failure population has been reported to be as high as 86%.  As frailty is also associated with ageing it seems inevitable that the incidence of frailty in the heart failure population will also rise leading to worse outcomes for this patient cohort. What can be done and how should we treat older frail heart failure patients to improve outcomes?