Senior Living: Heart failure and aging, a guide to managing the condition

By Dr. Andrew Yoon,

Contributing writer

The average person’s heart beats about 2.5 billion times over their lifetime, providing a continuous supply of oxygen and other nutrients to the brain and other vital organs. As people age, even a healthy heart can begin to weaken as a result of poor diet, lack of exercise, smoking, genetic disposition and other factors, which can lead to an increased risk of heart disease and ultimately heart failure.  

Many people confuse the term “heart failure” with heart attack. Heart failure is a condition where the heart is still working but at a reduced efficiency and not enough blood is being pumped to meet the body’s needs. A heart attack is one possible cause of heart failure. Most people with heart failure, however, have never had a prior heart attack and developed heart failure through other causes. 

Older adults are at greater risk for heart failure

Heart failure disproportionately affects older adults and is the leading cause of morbidity, hospitalization and mortality in those at least 65 years of age, according to the National Institutes of Health. Age-related changes may increase a person’s risk of heart disease. One major cause of heart disease is the buildup of fatty cholesterol deposits in the walls of the heart’s coronary arteries, which accumulate over a person’s lifetime. 

One challenge that older adults face is that the assessment, diagnosis and management of heart failure in the elderly is often complicated by other age-related diseases and medical conditions that can also affect the heart. 

Heart failure symptoms 

Common symptoms of heart failure for older adults include: 

• Chronic coughing and/or wheezing;
• Shortness of breath with physical exertion or when lying down;
• Swelling, especially of the lower extremities;
• Unexplained weight gain;
• Elevated heart rate;
• Fatigue;
• Lightheadedness;
• Loss of appetite; and
• Nausea.

When to see a doctor 

If an older adult or their caregiver is concerned that they are experiencing one or more of these symptoms, it is important that they see a doctor. If they are experiencing any of the following symptoms, however, it is time to call 911:

• Chest pain;
• Fainting or severe weakness;
• Rapid or irregular heartbeat associated with shortness of breath, chest pain or fainting; and
• Severe shortness of breath.

Heart failure management for older adults 

There are things you can do to delay, decrease or even reverse your risk for heart failure.

Here are some of the treatment regimens that a specialist may have a heart failure patient focus on: 

• Diet: When it comes to managing heart failure for older adults, diet is one of the most important aspects of treatment. Older adults and their caregivers should work with a physician to discuss the best diet options. Sodium and liquid intake should be limited according to the physician’s specifications;
• Exercise: When possible, patients with heart failure should participate in a monitored exercise program called cardiac rehabilitation, working closely with health care professionals to ensure they are participating in physical activities that best support their needs; and
• Medicine regimen: It is important that patients take their prescribed medications and not miss any doses. Some medicines will improve how well the heart pumps. Others remove excess fluid from the body or can even dilate blood vessels to help blood circulate more easily so that the heart doesn’t have to work as hard. Keep in mind that medications are prescribed specifically for each individual’s specific needs. Since older adults may have more than one chronic disease, condition or injury, they should not adjust their prescribed medications or take over-the-counter medications without first speaking to a doctor. If there are problems or side effects as a result of prescribed medications, call a doctor immediately for instructions. 

If an elderly friend or family member is living with heart failure, they can benefit from additional support. Here are some ways you can do that:

• Attend appointments with them;
• Regularly track their vital signs and weight;
• Maintain an accurate medication log;
• Keep a journal of their health journey ;
• Stay educated on their condition by asking plenty of questions during checkups;
• Watch for drug interactions, especially if any prescription dosages are changed or new medications are introduced;
• Visit the patient frequently enough to notice increases or decreases in activity, swelling, fluid intake and mental health, along with any other changes;
• Report any changes to the physician.

Heart failure in the elderly presents a range of challenges – but the seniors don’t have to face them alone. Find a MemorialCare Heart & Vascular Institute specialist who can support heart failure management at 800-MEMORIAL (800-636-6742) or memorialcare.org/LBHeart. 

Andrew Yoon, M.D., is the heart failure medical director at MemorialCare Heart & Vascular Institute.

Source: Orange County Register