Psychosocial considerations in elderly patients with heart failure. Freedland KE, Carney RM. Neuropsychiatric conditions, such as Alzheimer's dementia, and complications, such as delirium, are common in elderly patients with heart failure.Persistent alcohol abuse and cigarette smoking sometimes contribute to the onset and progression of heart failure.Major depression and other depressive disorders are common in this population and have adverse effects on functional status, quality of life, and prognosis.ersistent alcohol abuse and cigarette smoking sometimes contribute to the onset and progression of heart failure. Major depression and other depressive disorders are common in this population and have adverse effects on functional status, quality of life, and prognosis.