Management of coronary artery disease (CAD) is a large and growing challenge for today's burgeoning population of older adults, especially because age is a key risk factor for CAD and because morbidity/mortality from CAD increases with age. Whereas many people look to cardiovascular imaging to enhance CAD management, it often remains difficult to interpret the clinical implications of positive imaging studies. Functional assessment, heart rate and rhythm dynamics, and prognostic scoring tools all provide insights that complement the data provided by high-tech imaging options.