The demographic trend of aging is associated with an increased prevalence of comorbidities among the elderly. Physical, immunological, emotional and cognitive impairment, in the context of the advanced biological age segment, leads to the maintenance and precipitation of cardiovascular diseases. Thus, more and more data are focused on understanding the pathophysiological mechanisms underlying each fragility phenotype and how they potentiate each other. The implications of inflammation, sarcopenia, vitamin D deficiency and albumin, as dimensions inherent in fragility, in the development and setting of chronic coronary syndromes (CCSs) have proven their patent significance but are still open to research. At the same time, the literature speculates on the interdependent relationship between frailty and CCSs, revealing the role of the first one in the development of the second. In this sense, depression, disabilities, polypharmacy and even cognitive disorders in the elderly with ischemic cardiovascular disease mean a gradual and complex progression of frailty. The battery of tests necessary for the evaluation of the elderly with CCSs requires a permanent update, according to the latest guidelines, but also an individualized approach related to the degree of frailty and the conditions imposed by it. By summation, the knowledge of frailty screening methods, through the use of sensitive and individualized tools, is the foundation of secondary prevention and prognosis in the elderly with CCSs. Moreover, a comprehensive geriatric assessment remains the gold standard of the medical approach of these patients. The management of the frail elderly, with CCSs, brings new challenges, also from the perspective of the treatment particularities. Sometimes the risk–benefit balance is difficult to achieve. Therefore, the holistic, individualized and updated approach of these patients remains a desired objective, by understanding and permanently acquiring knowledge on the complexity of the frailty syndrome.

The increased incidence of hip fracture in the frail elderly patients requires the development of differentiated care, adapted to their physical, psychological and emotional profile. Pre- and postoperative comprehensive geriatric assessment (CGA) is the most accurate tool for developing a personalized therapeutic and care plan. Aim: To investigate the consequences of the surgical treatment of hip fractures on senior patients using CGA preoperatively and in the immediate postoperative period. Material and methods: The prospective study, from which we present the preliminary data, was conducted on a group of 95 patients admitted in the Trauma Clinic with hip fracture. Of these, only 59 underwent CGA preoperatively and 48 hours postoperatively. Particular attention was given to frailty - evaluated with Groningen Frailty Index (GFI), neurocognitive status - evaluated with Mini-Mental State Examination (MMSE), and psycho-emotional status - evaluated with Geriatric Depression Scale (GDS). Results: Analyzing the GFI scores (p = 0.014) it was found that of the preoperatively robust patients 71.4% became frail postoperatively. No statistically significant differences in cognitive and psycho-emotional status were found in the immediate postoperative compared to the initial preoperative assessment, probably due to the small sample size. Conclusions: The results of this study confirm the importance of evaluating the degree of frailty for the prediction of the postoperative evolution of hip fractures in senior patients.