Frailty, a syndrome characterized by an exaggerated decline in function and reserve of multiple physiological systems, is common in older patients with heart failure (HF) and is associated with worse clinical and patient-reported outcomes. Although several detailed assessment tools have been developed and validated in the geriatric population, they are cumbersome, not validated in patients with HF, and not commonly used in routine management of patients with HF. More recently, there has been an increasing interest in developing simple frailty screening tools that could efficiently and quickly identify frail patients with HF in routine clinical settings. As the burden and recognition of frailty in older patients with HF increase, a more comprehensive approach to management is needed that targets deficits across multiple domains, including physical function and medical, cognitive, and social domains. Such a multidomain approach is critical to address the unique, multidimensional challenges to the care of these high-risk patients and to improve their functional status, quality of life, and long-term clinical outcomes. This review discusses the burden of frailty, the conceptual underpinnings of frailty in older patients with HF, and potential strategies for the assessment, screening, and management of frailty in this vulnerable patient population.

衰弱是一种以多个生理系统的功能和储备过度下降为特征的综合征，在患有心力衰竭 (HF) 的老年患者中很常见，并且与较差的临床和患者报告的结果相关。尽管已经开发了几种详细的评估工具并在老年人群中进行了验证，但它们很麻烦，没有在心力衰竭患者中得到验证，并且在心力衰竭患者的常规管理中并不常用。最近，人们对开发简单的衰弱筛查工具越来越感兴趣，这些工具可以在常规临床环境中有效、快速地识别衰弱的心力衰竭患者。随着老年心衰患者的虚弱负担和认识的增加，需要一种更全面的管理方法，针对多个领域的缺陷，包括身体功能和医疗、认知和社会领域。这种多领域方法对于解决这些高危患者护理所面临的独特的、多维的挑战以及改善他们的功能状态、生活质量和长期临床结果至关重要。本综述讨论了衰弱的负担、老年心力衰竭患者衰弱的概念基础，以及评估、筛查和管理这一弱势患者群体衰弱的潜在策略。