TABLE 4.

Strategies and Potential Interventions for Managing Geriatric Conditions

Geriatric Condition	Strategies for Enhanced Care Provision	Interventions Requiring Additional Study
Malnutrition	• Referral to dietitian/nutritionist • Consideration of nutritional supplements • Dietary recommendations (eg, increasing caloric intake and/or liberalizing dietary restrictions) • Assessment of external factors that may be contributing to malnutrition (eg, financial means, taste, dental issues, social support)	• Dietary modifications • Nutritional/caloric supplementation • Combining nutritional interventions with exercise • Home-delivered meals • Micronutrient supplementation
Cachexia	• Consideration of nutritional supplements • Dietary recommendations (eg, increasing caloric intake and/or liberalizing dietary restrictions) • Consideration for palliative care	• Treatment of underlying causes such as heart failure and other comorbid conditions • Appetite stimulants • Dietary modifications • Nutritional/caloric supplementation
Sarcopenia	• Referral to physical and/or occupational therapy; provision of exercise prescription • Exercise and resistance training • Reassessment of prognosis and risk-benefit ratio of management options	• Treatment of underlying causes such as heart failure (eg, effect of GDMT) and other comorbid conditions • Nutritional/caloric supplementation • Resistance exercise training • Testosterone replacement
Frailty	• Reassessment of prognosis and risk-benefit ratio of management options • Emphasis on lifestyle recommendations such as exercise (home programs, cardiac rehabilitation programs, and strength-training) and nutrition	• Exercise
Cognitive impairment	• Engagement of social support (caregivers, family), services • Referral for formal assessment and/or discussion with other clinicians (geriatrics and/or memory center) • Reassessment of health goals/priorities • Reassessment of prognosis and risk-benefit ratio of management options (especially related to medications) • Consideration of novel agents to treat early Alzheimer dementia if present • Consideration for palliative care	• Treatment of underlying causes such as heart failure and other comorbid conditions • Exercise

GDMT = guideline-directed medical therapy.