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Introduction: Heart failure (HF) in the elderly is frequently associated with limited therapeutic options and may cause severe complications. Unfortunately, these patients are often excluded from clinical trials., Objectives: The aim of the study was to determine the relationship between HF, coexisting diseases, and use of medications in patients of advanced age living in nursing homes., Patients and Methods: The study group included 79 women and 21 men between 65 and 102 years of age living in 2 nursing homes. Information about the health status of patients was gathered from history and medical records. We conducted a physical examination and, in eligible cases, also an orthostatic test. Comorbidity was assessed using the age‑adjusted Charlson comorbidity index (ACCI)., Results: The prevalence of HF was 26%. The number of chronic diseases coexisting with HF was remarkably higher than the number of diseases among patients without HF (median, 6 [0-11] vs. 3 [0-8]; P <0.0001). The ACCI was also higher in the HF group compared with patients without HF (median, 7 [5-12] vs. 5.5 [2-9]; P <0.0001). Patients with HF took significantly more medications, although HF was treated according to the current guidelines in less than half of the cases., Conclusions: Our data revealed that HF is associated with significant morbidity and polypharmacy. There is a need for further research that would guide therapy of HF in elderly patients with limited life expectancy and multiple comorbidities as inhabitants of nursing homes. Nonetheless, the current treatment of nursing home patients with HF seems to be suboptimal.

Frailty syndrome (FS) and cognitive impairment are associated with an increased risk of falls, disability, hospitalization and death. We investigated prognostic meaning of FS and cognitive impairment in persons ≥ 65 years, living in 2 nursing homes. Information about the health status of patients was gathered from history, medical documentation, test assessing FS, according to the Canadian Study of Health and Aging-Clinical Frailty Scale (CSHA-CFS) and the Mini-Mental State Examination (MMSE). The study group included 66 women and 20 men, between 66 and 101 years of age (mean ± S.D.=83.8 ± 8.3 years). The frequency of severe frailty (CSHA-CFS=7) among the elderly living in nursing homes was 34.9%, while severe cognitive impairment (MMSE<18) was present in 55.8%. Residents with severe FS and MMSE<18 consisted 33.7% of examined and 50.0% of those who died during 12-month follow-up, p<0.05. Individuals with severe FS and severe cognitive impairment (n=29) as compared to all other patients, were significantly less probable (59% vs. 79%, p=0.03) to survive one year. Neither frailty, nor dementia, nor severe FS or cognitive impairment when considered separately was associated with higher mortality rate. The risk assessment in severely disabled geriatric patients is best performed with measures of functional and cognitive function considered jointly, but not separately., (Copyright © 2011. Published by Elsevier Ireland Ltd.)