Clinical manifestation of HF in older adults may be atypical and diagnostic assessment might be delayed. Assessment of HF in older adults may be made simple by following a simple 5-step process, DEFEAT HF: Diagnosis, Etiology, Fluid status, Ejection fraAcion, and Treatment for HF (see Box 2). A thorough history and a careful physical examination should allow proper clinical diagnosis of HF in most cases. An underlying cause for HF must be identified, preferably in collaboration with a cardiologist. All patients who have HF should be assessed carefully for volume status to achieve euvolemia. LVEF must be determined in all patients with a clinical diagnosis of HF to assess prognosis and guide therapy. All HF patients should be treated with evidence-based therapies according to the recommendations of a major national HF guideline. © 2006 Elsevier Inc. All rights reserved.