Despite the prevalence and significant morbidity and mortality for older adults related to CV disease, only one-half of the elderly with diagnosed PAD are symptomatic. The elderly have complex comorbidities, physical or cognitive disabilities, and frailty, which negatively impact assessing the common symptoms associated with PAD adequately. The advancement of critical limb ischemia, including tissue loss, is often the initial presentation related to higher rates of limb loss and CV events.
The poor prognosis of critical limb ischemia demands early and rapid clinical assessment, initiation of wound care when appropriate, and referral for the possibility for surgical revascularization to decrease the incidence of a CV event or major amputation. The treatment of the elderly with PAD is multidisciplinary in its approach. Therefore, it is vital to equip the advanced practice nurse caring for these patients with the knowledge and skills needed to recognize and diagnose PAD and understand the management for the patient and when to refer the patient for a vascular evaluation.