Strategies for Optimizing Heart Failure Care in the Older Adults

Updated: June 18, 2026

Illustration showing domain-based strategies to optimize care in older adults with heart failure.
  • Heart failure (HF) in older adults is a growing and distinct clinical challenge, yet proven therapies—especially guideline-directed medical therapy (GDMT)—remain underused despite evidence that older patients can benefit.
  • Care for older adults with HF must go beyond standard treatment algorithms, accounting for frailty, multimorbidity, polypharmacy, cognitive/physical function, social needs, and patient goals through shared decision-making.
  • The paper advocates a practical, multidimensional care model that includes domain-based assessment, deprescribing when appropriate, early advance care planning, specialist/palliative care referral, and system-level tools to improve equitable GDMT implementation.