According to a new study in the Canadian Journal of Cardiology, published by Elsevier, showed that older individuals have the most to gain and main gain the most from rehabilitation programs, but this need is often ignored.
The study findings say that regular exercise is highly beneficial for all patients with cardiovascular disease regardless of age. Their results also indicate that patients who benefited most from cardiac rehabilitation were those who started out with the greatest physical impairment.
The researchers noted that older patients are at a higher risk for complications and accelerated physical deconditioning after a cardiovascular event, yet these patients are largely underrepresented in rehabilitation programs. Studies have shown that this might be due to a lack of referral and encouragement to attend cardiac rehabilitation in older patients.
“Aging is associated with several factors such as increased inflammation or oxidative stress that predispose people to cardiovascular diseases. As a result, elderly patients are usually less fit than their younger counterparts, and deconditioning is accelerated once cardiovascular disease is established,” explained lead investigator Gaëlle Deley, PhD, Faculty of Sports Sciences, University of Burgundy Franche-Comté, Dijon, France, in a statement announcing the study’s findings.
“However, there are few data about the impact of patient age on the physical and psychological effectiveness of cardiac rehabilitation,” says Deley.
Several studies have looked at the effects of cardiac rehabilitation in older adult, say the researchers, noting these data often focus on patients above the age of 65 with no distinction between old and very old patients and examine either physical or psychological outcomes but not both.
Looking at Impact of Cardiac Rehabilitation on Older Patients
The goal of this study was to compare the effects of an exercise‐based cardiac rehabilitation program on physical and psychological parameters in young, old, and very old patients. It also aimed to identify the features that best predicted cardiac rehabilitation outcome.
All patients referred to Cardiac Rehabilitation at the Clinique Les Rosiers, Dijon, France from January 2015 to September 2017 were included in this single-center prospective study. Investigators examined 733 patients who completed a 25-session cardiac rehabilitation program. They were divided into three subgroups: less than 65 years old; between 65 and 80 years old; and 80 years or older. Physical and psychological variables such as scores of anxiety and depression were evaluated for all patients before and after cardiac rehabilitation.
Following the intervention, all patients experienced improvements. “We found a few weeks of exercise training not only significantly improved exercise capacity, but also decreased anxiety and depression. Patients with the greatest physical impairments at baseline benefited the most from exercise,” commented Dr. Deley. “Another interesting result was that patients younger than 65 who were very anxious before rehabilitation benefited the most from exercise training. A similar result was found for depressed patients older than 65. These improvements will surely have a great positive impact on patients’ independence and quality of life and might help both clinicians and patients to realize how beneficial exercise rehabilitation can be,” he said.
Cardiovascular diseases are the main cause of death globally. Nearly 18 million people died from cardiovascular diseases in 2016, representing over 30 per cent of all global deaths according to the World Health Organization. While cardiovascular diseases increasingly affect young people, the number of people above the age of 65 years, and even more above the age of 80 years, dying from cardiovascular diseases is also increasing.
