The burden of heart failure is rapidly rising. Heart failure is associated with substantial mortality, morbidity, and economic cost, which disproportionately affect older adults. Heart failure among older individuals is frequently complicated by geriatric syndromes, including frailty, functional decline, cognitive impairment, and atypical clinical presentations. Understanding the nature of these geriatric syndromes and their impact on the assessment and management of heart failure is a critical component to diagnosing and delivering appropriate care to these patients. In this article we review the geriatric aspects of heart failure.
Key words: geriatric syndrome, heart failure, older adults, diagnosis, frailty.

Jonathan M. Flacker, MD, Division of Geriatric Medicine and Gerontology, Emory University School of Medicine, Atlanta, GA, USA.

The term "Geriatric Syndrome" is commonly used but ill defined. In publications, authors claim that all sorts of conditions are a "Geriatric Syndrome", including, but not limited to, delirium,¹ dementia,¹ depression,² dizziness,³ emesis,⁴ falls,¹ gait disorders,¹ hearing loss,¹ insomnia,¹ urinary incontinence,¹ language disorders,¹ functional dependence,⁵ lower extremity problems,⁶ oral and dental problems,⁶ malnutrition,¹ osteoporosis,¹ pain,¹ pressure ulcers,¹ silent angina pectoris,⁷ sexual dysfunction,⁶ syncope⁶ and vision loss.¹ Can this be possible? Can any condition commonly encountered in older adults be a "Geriatric Syndrome"?

The Origins of "Syndrome"
The word syndrome seems to have appeared in an English translation of Galen in about 1541.⁸ Derived from the Greek roots "syn" (meaning "together") and "dromos" (meaning "a running"), this term generally refers to "a concurrence or running together of constant patterns of abnormal signs or symptoms".