Table 1.

Principal domains, components and tools for frailty patients with cardiovascular disease enrolled to Cardiac Rehabilitation programs.

Domains	Components	Tools	Interpretation and/or Norm Values	Interventions
Functional Capacity	Exercise capacity	Muscle fatigue, Gait Speed, 6MWT	Gait speed > 0.8 m/s: 6MWT must re-performed in time (patient itself control)	Endurance and/or resistance training
	Muscle strenght	Handgrip	Handgrip (Fried’s criteria): Men ≥ 29–32 kgf and Women ≥ 17–21 kgf (adjusted for BMI)	Resistance training
	Balance	Tinetti scale/SPPB	Fall risk is moderate to high if SPPB < 10 and Tinetti scale < 25	Balance and coordination training
	Sarcopenia	Gait speed/SPPB	Gait speed > 0.8 m/s, Handgrip (Fried’s criteria): Men ≥ 29–32 kgf and Women ≥ 17–21 kgf (adjusted for BMI), SPPB < 10	Endurance walking exercise
	Energy expenditure	MLTAQ-short version	Kcal/week expended: Men < 383 Women < 270	Reduce sedentary time and increase daily-life activity
	Dependency	ADL/IADL	Reach independence: ≥4/6 items, ≥6/8 items	Provide functional exercises relevant to daily life
Comorbidity	Number and severity of chronic conditions	Medical record analysis, CIRS	Check for major (chronic) conditions	Tailor intervention based on medical history
	Bleeding risk	HAS-BLED, PRECISE-DAPT score	HAS-BLED 5–8 High risk; PRECISE-DAPT score ≥ 25 Short DAPT	Optimize therapy: Standard/long DAPT (12–24 months), short DAPT (3–6 months)
	Polypharmacy	Teraphy check	Number/ indication of single drug	Avoid adverse combinations and/or reduce unnecessary medications
	Anemia	Laboratory testing	Serum Hemoglobin level: Men >13 g/dL Women >12 g/dL (check MCV, iron blood levels, serum ferritin, TIBC, Vitamin B12, folate)	Consider iron prescription/erythropoetin
	Albuminemia	Laboratory testing	Serum Albumin 3.5–4.5 mg/dL	Nutritional counseling
	Diabetes	Laboratory testing and clinical examination	Fasting plasma glucose >100 mg/dL and HbA1c <6.0%; Check diabetes neuropathy, retinopathy	Elevate physical activity, health nutrition with weight loss and/or prescription of metformin
	Dyslipidemia	Laboratory testing	Total Cholesterol, LDL cholesterol, TG, norm value dependent on CV risk	Elevate physical activity, health nutrition with weight loss and/or prescription of statin
	Thyroid dysfunction	Laboratory testing	TSH, FT3, FT4: normal value dependent on age and sex	Check periodically
	Renal dysfunction	Laboratory testing	Blood Urea Nitrogen, Creatinine, eGFR, normal value dependent on age and sex	Check periodically
	Liver dysfunction	Laboratory testing	AST, ALT, GGT, normal value dependent on age and sex	Check periodically
	Hypovitaminosis	Laboratory testing	25-OH-vitaminD (>30 ng/mL)	Consider prescription of 25-OH-vitaminD or Calcifediol
	Disturbed blood pressure	BP assessment	Systolic blood pressure target in elderly no lower than 130 mmHg	Consider pharmacotherapy in case of hypotension or hypertension
	Hearing loss	Audiometry	Impaired hearing function, especially conversational frequencies	Consider hearing aids
	Pulmonary dysfunction	Spirometry	Check FEV and Tiffenau index	Consider specialist counseling
	Cardiac dysfunction	Ecocardiography/Laboratory testing	Ejection fraction % ≥ 55, E/A ratio ≥ 1, NT-proBNP < 450 pg/mL (in 75–99 years)	Optimize therapy
Nutritional status	Calories intake	MNA	Check for adequate calorie intake	Promote sufficient calories intake
	Protein intake	NRS 2002	Check for adequate protein intake: in elderly around 1–1.2 g/kg/day	Promote healthy protein-rich food items
	Loss of appetite	Self-reported unexplained weight loss	More than 4.5 kg or 5% of body weight in past year	Promote sufficient calories and protein intake
	Water intake	Dehydratation	Check for water intake	Promote water intake adequate on singular needing
Cognitive Function	Memory and executive functions	MMSE	Detect Mild Cognitive Impairment (MCI): MMSE < 26 points (age and scholar correction)	Consider specific diagnostic study
Physicological function	Mood	GDS	Check for mood disorders if GDS < 10 points	Consider specific diagnostic study
	Cognition	MINI-Cog test	Score ≥ 3 indicate lower likelihood of dementia	Consider specific diagnostic study
Social Support	Family or community support	Caregiver presence	Check for family support	Help organising faimily support
	Financial resources		Check for financial issues/constraints	Refer to social worker if needed
	Smoking behaviour	Anamnesis	Avoid active and passive smoking	Quit smoking and/or avoid smoking exposure

Captions: 6MWT, 6 min walking test; ADL/IADL, Activities of daily living/Instrumental activities of daily living; AST, Aspartate Aminotransferase; ALT, Alanine Aminotransferase; BMI, Body mass index; BP, Blood Pressure; CIRS, Cumulative Illness Rating Scale; CPET, Cardiopulmonary exercise test; CV risk, Cardiovascular risk; DAPT, Dual Antiplatelet Therapy; eGFR, Estimated glomerular filtration rate; FEV, Forced Expiratory Volume; GGT, Gamma-Glutamyl Transferase; GDS, Geriatric depression scale; HASBLED score, Hypertension, Abnormal renal/liver function, Stroke, Bleeding history, Labile International Normalized Ratio or INR, Elderly >65 years, Drugs/alcohol concomitantly; HbA1c, Glycated Hemoglobin; LDL cholesterol, Low Density Lipoprotein; MCV, Mean Corpuscular volume; MLTAQ-short version, Minnesota Leisure Time Activity Questionnaire; MMSE, Mini mental state examination; MNA, Mini nutritional assessment; NRS 2002, Nutritional risk screening; NT-pro-BNP, N terminal pro-brain natriuretic peptide; PRECISE-DAPT, PREdicting bleeding Complications In patients undergoing Stent implantation and subsEquent DAPT; SPPB, Short physical performance battery; TG, Triglycerides; TIBC, total iron binding capacity; FT3, Free Triiodothyronine; FT4, Free Thyroxine; TSH, Thyroid-stimulating hormone.