Regular exercise is hugely beneficial for all cardiovascular disease patients regardless of age, the researchers report in the Canadian Journal of Cardiology, published by Elsevier. Their results showed that the patients who benefited most from cardiac rehabilitation were those who started with the greatest physical disability.
Elderly patients are at higher risk for complications and accelerated physical deconditioning after a cardiovascular event, but older patients are largely underrepresented in rehabilitation programs. Studies have shown that this may be due to a lack of referrals and encouragement to participate in cardiac rehabilitation in older patients.
“Aging is associated with several factors such as increased inflammation or oxidative stress that predispose people to cardiovascular disease. As a result, elderly patients are generally less fit than their younger peers and deconditioning is accelerated once cardiovascular disease has established, “explained principal investigator Gaëlle Deley, PhD, INSERM UMR1093 – CAPS, Faculty of Exercise Science, University of Franche-Comté Burgundy., Dijon, France. “However, there are few data on the impact of the patient’s age on the physical and psychological efficacy of cardiac rehabilitation.”
Several studies have looked at the effects of cardiac rehabilitation in the elderly. However, these data often focus on patients over the age of 65 with no distinction between elderly and very elderly patients and examine physical or psychological outcomes but not both.
The objective of this study was to compare the effects of an exercise-based cardiac rehabilitation program on physical and psychological parameters in young, elderly and very elderly patients. It also aimed to identify the characteristics that best predicted cardiac rehabilitation outcomes.
All patients referred for cardiac rehabilitation at Clinique Les Rosiers, Dijon, France from January 2015 to September 2017 were included in this single-center prospective study. The researchers looked at 733 patients who completed a 25-session cardiac rehabilitation program. They were divided into three subgroups: under 65; between 65 and 80 years; and 80 years or older. Physical and psychological variables such as anxiety and depression scores were assessed for all patients before and after cardiac rehabilitation.
After the surgery, all patients experienced improvements. “We found that a few weeks of physical training not only significantly improved exercise capacity, but also reduced anxiety and depression. Patients with the greatest physical disabilities at baseline benefited the most from exercise, “commented Dr. Deley.” Another interesting finding was that patients under the age of 65 who were very anxious prior to rehabilitation had benefited most from exercise. A similar result was found for depressed patients over the age of 65. These improvements will certainly have a great positive impact on patients’ independence and quality of life and could help both doctors and caregivers. patients to realize how useful rehabilitation with physical exercise can be “.
In an accompanying editorial, Codie R. Rouleau, PhD, RPsych, Clinical Psychologist, Adjunct Assistant Professor in Psychology, and James A. Stone, MD, PhD, Clinical Professor of Medicine, both at the University of Calgary and TotalCardiology Research Network in Calgary, AB, Canada, point out that the study’s conclusion that age does not limit physical performance results is inconsistent with some previous research showing that advancing age, particularly for patients aged equal to or over 60, is associated with lower cardiorespiratory fitness gains during cardiac rehabilitation. The reasons may relate to different program characteristics, different methods of measuring physical performance, or the exceptional adherence rate reported in the study (on average 98.6% of the prescribed sessions participated).
“Seniors who are eligible for cardiac rehabilitation are less likely to receive a referral than their younger peers, and this report can serve as a catalyst for physicians to recognize that seniors with coronary artery disease will only benefit if referred and given. opportunity to participate “, commented Dr. Rouleau.
“A strength of this work is examining changes in psychosocial well-being during cardiac rehabilitation, an under-researched result that is often highly regarded by patients,” added Dr. Stone. “The work of Deley et al. it can help inform strategies to increase the effects of rehabilitation, reach more patients with a greater likelihood of reaping clinical benefits, and get better outcomes from higher-value healthcare. ”
Cardiovascular disease is the leading cause of death globally. Nearly 18 million people died from cardiovascular disease in 2016, accounting for more than 30% of all global deaths according to the World Health Organization. As cardiovascular disease affects young people more and more, the number of people over the age of 65, and even more so over the age of 80, who die from cardiovascular disease is also increasing.