Contact: Olivia Walther, owalther@acc.org,

WASHINGTON (Aug 10, 2026) -

Older adults with cardiovascular disease (CVD) often have coexisting cognitive impairment and frailty, conditions that can significantly affect treatment decisions, recovery, independence and quality of life and should be considered as part of an aging-informed approach to care, according to a new American College of Cardiology Scientific Statement published in JACC, the flagship journal of the ACC.

An estimated one-third of patients seen in cardiology clinics have some degree of cognitive impairment, while frailty affects approximately one-half of community-dwelling older adults and two-thirds of older adults undergoing percutaneous coronary intervention.

The statement reviews the interconnected relationship between cardiovascular disease, cognitive impairment and frailty and outlines practical, consensus-based strategies for prevention, screening, assessment and management.

“This statement reframes cardiovascular care for older adults beyond a traditional disease-centered model to a more aging-informed, function-centered approach,” said Karen P. Alexander, MD, FACC, chair of the scientific statement’s writing committee and professor of medicine at Duke University School of Medicine. “For many older adults, the most important outcomes are not prevention of cardiovascular events, but maintaining cognitive health, physical function, and independence.”

According to the statement, cardiovascular disease, cognitive impairment and frailty share many risk factors and underlying biological mechanisms, including vascular dysfunction, chronic inflammation and age-related declines in physiological reserve. The authors note that these conditions frequently coexist and can influence treatment tolerance, medication adherence, recovery from cardiovascular procedures and the ability to maintain independence.

Key Recommendations for clinicians:

• Consider cardiovascular disease in the context of biological aging rather than chronological age alone.
• Address shared modifiable risk factors and social and environmental health drivers.
• Implement screening for cognitive impairment and frailty in outpatient settings and following hospitalization if feasible.
• Pursue diagnostic evaluation and timely referral when impairment is suspected.
• Promote resilience through multicomponent interventions, including cardiac rehabilitation, multidomain exercise, nutritional optimization and thoughtful medication management to reduce polypharmacy-related harms.

The statement also highlights evidence gaps and calls for greater inclusion of older adults in cardiovascular research, emphasizing the need for studies that measure outcomes most meaningful to patients, including independence, mobility, cognitive function and caregiver burden.

For an embargoed copy of Cognitive Impairment and Frailty in Older Adults With Cardiovascular Disease: A 2026 ACC Scientific Statement, contact JACC Media Relations Manager Olivia Walther at owalther@acc.org.

The American College of Cardiology (ACC) is a global leader dedicated to transforming cardiovascular care and improving heart health for all. For more than 75 years, the ACC has empowered a community of over 60,000 cardiovascular professionals across more than 140 countries with cutting-edge education and advocacy, rigorous professional credentials, and trusted clinical guidance. From its world-class JACC Journals and NCDR registries to its Accreditation Services, global network of Chapters and Sections, and CardioSmart patient initiatives, the College is committed to creating a world where science, knowledge and innovation optimize patient care and outcomes. Learn more at www.ACC.org or connect on social media at @ACCinTouch. 

The ACC’s JACC Journals rank among the top cardiovascular journals in the world for scientific impact. The flagship journal, the Journal of the American College of Cardiology (JACC) — and specialty journals consisting of JACC: Advances, JACC: Asia, JACC: Basic to Translational Science, JACC: CardioOncology, JACC: Cardiovascular Imaging, JACC: Cardiovascular Interventions, JACC: Case Reports, JACC: Clinical Electrophysiology and JACC: Heart Failure — pride themselves on publishing the top peer-reviewed research on all aspects of cardiovascular disease. Learn more at JACC.org.  

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