Tafamidis delivered a 56% mortality reduction over 24 months in patients aged 80+ with transthyretin cardiac amyloidosis, a condition where misfolded proteins accumulate in heart tissue. The French cohort study of 465 patients also found 35% fewer heart failure hospitalizations at 12 months compared to untreated controls. This represents the first substantial evidence for tafamidis efficacy in octogenarians, a population typically excluded from cardiac amyloid trials despite representing the majority of wild-type cases. The protein stabilizer works by preventing transthyretin from unfolding and forming toxic fibrils that progressively destroy cardiac function. These results are particularly significant given that transthyretin amyloidosis was historically considered untreatable until tafamidis approval in 2019. The magnitude of benefit rivals that seen in younger populations, challenging assumptions about treatment futility in advanced age. However, the observational design introduces potential bias despite propensity weighting, and the 24-month minimum treatment requirement may have selected healthier patients. The findings strongly support extending tafamidis access to elderly patients, who face the highest disease burden but often encounter treatment hesitancy due to age-related concerns about drug tolerance and life expectancy.