Does a cardiac rehabilitation program enhanced with psychological support improve psychophysical health and reduce post-discharge medical events in elderly inpatients aged ≥75 with heart disease?
Integrating psychological support into cardiac rehabilitation for elderly patients aged ≥75 improves psychophysical health and delays subsequent emergency department visits and rehospitalizations.
BACKGROUND: Elderlies in cardiac rehabilitation show a particular frailty due to specific aging issues, thus specific professional psychophysical care is required. AIM: This study aimed at evaluating the effect of a cardiac rehabilitation program enhanced with psychological support on the psychophysical health of elderly subjects aged ≥75. Moreover, the association of psychophysical conditions with the long-term post-discharge course of medical events was examined. DESIGN: This retrospective cohort study was conducted on elderly patients aged ≥75 admitted from 2015 to 2019 to a cardiac rehabilitation program including psychological support. SETTING: The cardiac ward and the psychology unit of a post-acute clinical rehabilitation Institute. POPULATION: A total of 523 elderly inpatients (44% females), aged ≥75 years (mean 79.7±3.46 years), admitted to a cardiac rehabilitation ward due to heart disease. METHODS: Psychological and functional variables such as depression, quality of life, and Barthel Index were measured at hospitalization and at discharge. The medical events after discharge such as emergency department accesses and rehospitalizations were registered. RESULTS: Cardiac rehabilitation showed significant improvements both in elderlies' psychological and physical health. Higher depression levels predicted a worse post-discharge course. Patients who received psychological intervention accessed emergency department and were re-hospitalized significantly later than the others. CONCLUSIONS: Cardiac comprehensive rehabilitation can significantly improve the psycho-physical health of elderly subjects aged ≥75 who benefit of psychological support. Psychological support can enhance the psychophysical health of great elder inpatients in cardiac rehabilitation. CLINICAL REHABILITATION IMPACT: Given the associations with short and long-term outcomes, health professionals should take care of the psychological conditions of elderlies (e.g., depression) by integrating psychological interventions in cardiac rehabilitation in order to promote the elderlies' psychophysical conditions, quality of life, as well as more favorable medical outcomes.
Balestroni et al. (Fri,) studied this question.
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