Elderly patients with cardiovascular disease are increasingly referred for complex, high-cost interventions, including cardiac surgery. Many elderly patients have good outcomes, but others have complications and poor outcomes irrespective of the treatment received, because of frailty, cognitive impairment or poor general health. For these patients, major interventions such as coronary artery bypass may be less appropriate. However, these aspects of 'general health' are usually not systematically assessed. The proposed Project will evaluate simple measures of frailty, co-morbidity, cognitive function, and general health in elderly patients with ischemic heart disease admitted to hospitals throughout New Zealand. It will also assess how this information may modify clinical care, including potentially avoiding major interventions, morbidity and reduced quality of life for those unlikely to benefit.