Key result
Frailty was associated with significantly lower odds of establishing exercise habits following outpatient cardiac rehabilitation compared to non-frail, non-depressed patients (OR 0.35; 95% CI 0.14-0.85; p=0.005).
Why the study?
It was unknown whether patients undergoing outpatient cardiac rehabilitation with frailty and depressive symptoms at discharge are less likely to establish positive exercise habits.
Do frailty and depressive symptoms reduce the establishment of exercise habits in patients undergoing outpatient cardiac rehabilitation?
Cohort (n=242)
No
Do frailty and depressive symptoms reduce the establishment of exercise habits in patients undergoing outpatient cardiac rehabilitation?
Frailty at the end of cardiac rehabilitation is significantly associated with a lower likelihood of establishing positive exercise habits, highlighting the need for frailty prevention interventions.
To assess whether patients undergoing outpatient cardiac rehabilitation who have frailty and depressive symptoms at discharge are less likely than those without these condition to establish positive exercise habits. A retrospective cohort study that involved the assessment of frailty and depressive symptoms at the end of a three-month course of cardiac rehabilitation. Frailty was defined as the patient noting three or more items using the criteria of Fried et al., while depressive symptoms were delineated by Patient Health Questionnaire-9 (PHQ-9) scores of 10 or greater. General hospital (1048 beds) with outpatient cardiac rehabilitation in a suburb location in Japan. 344 individuals underwent outpatient cardiac rehabilitation during the January 1, 2019-June 1, 2022, study period. Of these, the findings of 242 (mean age: 68.2 ± 11.1 years) were analyzed as 48 individuals were excluded due to not completing the course and 54 lacked outcome data. Not applicable. The establishment of an exercise habit defined as exercising at least 2 days per week and 30 minutes per day. Participants were divided into four groups depending upon the presence or absence of frailty and depressive symptoms: non-frail with no reported depressive symptoms (173 subjects), frailty-only (21 subjects), depressive symptoms-only (38 subjects), and frailty and depressive symptoms (10 subjects). Compared with patients who were not depressed and not frail, those with frailty only (odds ratio: 0.43, 95% confidence interval: 0.21-0.88, p= 0.02) and those with frailty and depressive symptoms (odds ratio: 0.21, 95% confidence interval: 0.05–0.82, p= 0.025) had significantly lower odds ratios for establishing exercise habits. After multivariate adjustment, the odds ratio of establishing an exercise habit was significantly lower in those with only frailty (odds ratio: 0.35, 95% confidence interval: 0.14–0.85, p= 0.005). This study, while limited by the small number of subjects with both frailty and depressive symptoms, indicates that interventions to prevent frailty during hospitalization and cardiac rehabilitation may be essential for cardiovascular disease patients with frailty whether or not associated with depressive symptoms.
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Yokote et al. (2023) conducted a cohort in outpatient cardiac rehabilitation (n=242). Frailty vs. No frailty and no depressive symptoms was evaluated on Establishment of an exercise habit (exercising at least 2 days per week and 30 minutes per day) (OR 0.35, 95% CI 0.14-0.85, p=0.005). Frailty was associated with significantly lower odds of establishing exercise habits following outpatient cardiac rehabilitation compared to non-frail, non-depressed patients (OR 0.35; 95% CI 0.14-0.85; p=0.005).
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