Frailty Over Time: A 6-MONTH FOLLOW-UP OF MULTIDISCIPLINARY CARDIAC AND PULMONARY REHABILITATION IN OLDER ADULTS WITH CARDIORESPIRATORY DISEASE

Purpose: Chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) are associated with psychological distress, reduced health-related quality of life (HRQoL), and functional decline, particularly in older adults where frailty is a growing concern. This study primarily evaluated the effects of cardiac and pulmonary rehabilitation on frailty, as measured by the Clinical Frailty Scale, while also examining secondary outcomes including psychological distress, self-efficacy, and HRQoL. Methods: In this multicentric observational study, participants were evaluated through clinical, psychological, functional, and frailty measures at baseline (T 0 ), discharge (T 1 ), and 6-month follow-up (T 2 ). Results: A total of 195 older inpatients (age ≥65 years) with CHF or COPD were included. Significant improvements were observed over time in psychological distress (T 0 = 3.7 ± 2.6, T 1 = 2.0 ± 2.0, T 2 = 2.1 ± 2.3; P < .0001), HRQoL (T 0 = 58.9 ± 19.7, T 1 = 68.3 ± 19.0, T 2 = 63.1 ± 20.3; P < .0001), and self-efficacy (T 0 = 18.56 ± 3.16, T 2 = 19.41 ± 2.87; P = .0005), while frailty remained stable (T 0 = 3.9 ± 1.1, T 1 = 3.8 ± 1.0, T 2 = 3.9 ± 1.0; P = .12). Regression analysis identified age, sex, Barthel Index score, Braden Scale score, HRQoL, self-efficacy, and Short Physical Performance Battery score as significant predictors of frailty at T 2 . Conclusion: Despite improvements in psychological and HRQoL outcomes in older adults with CHF or COPD, frailty remains a challenge, emphasizing the need for interventions targeting physical, psychological, and functional domains. Further research is needed to explore novel or improved rehabilitation strategies and their effect on long-term outcomes.