Cardiac rehabilitation in frail older adults with cardiovascular disease improved physical function similarly to nonfrail patients, including greater improvements in Timed Up & Go (P=0.007).
Cohort (n=243)
Does phase II cardiac rehabilitation improve physical function in frail older adults with cardiovascular disease compared to intermediate-frail and nonfrail adults?
Cardiac rehabilitation improves physical function in frail older adults with CVD to a similar or greater extent than in less frail patients, supporting their referral to CR.
p-value: p=0.007
PURPOSE: Frailty is highly prevalent among older adults with cardiovascular disease (CVD) and is associated with greater than 2-fold risk for morbidity and mortality, independent of age and comorbidities. Many candidates are not referred to cardiac rehabilitation (CR) under the assumption that they are too frail to benefit. We hypothesized that CR is associated with similar benefits for frail adults as for intermediate-frail and nonfrail adults. METHODS: Retrospective analysis of CVD patients who completed a phase II CR program. Patients classified as frail by meeting ≥2 frailty criteria and intermediate-frail by meeting 1 criterion, including 6-min walk distance (6MWD) <300 m, gait speed ≤0.65 m/sec or 0.76 m/sec normalized to height and sex, tandem stand <10 sec, Timed Up 75 were classified as frail, 70 as intermediate-frail, and 98 as nonfrail. Each group improved in all measures of frailty except for tandem stand. There were no significant differences in pre- to post-CR measures for 6MWD, gait speed, tandem stand, or hand grip strength between groups. Frail patients showed greater improvement in TUG than the other groups (P = .007). CONCLUSION: Among frail patients, CR was associated with improvements in multiple domains of physical function. Gains achieved by frail adults were similar to or greater than those achieved by intermediate-frail and nonfrail patients. These data provide strong rationale for referring all eligible patients to CR, including frail patients. Those who are most physically impaired may derive gains that have proportionally greater ramifications.
Lutz et al. (Fri,) conducted a cohort in Cardiovascular disease (n=243). Phase II cardiac rehabilitation vs. Intermediate-frail and nonfrail patients was evaluated on Changes in physical function measures (6MWD, gait speed, tandem stand, TUG, hand grip strength) (p=0.007). Cardiac rehabilitation in frail older adults with cardiovascular disease improved physical function similarly to nonfrail patients, including greater improvements in Timed Up & Go (P=0.007).