Cardiovascular responses during bed‐to‐wheelchair transfers in frail elderly who live at home*

Background: The objective of this study is to determine the changes in cardiovascular responses during bed‐to‐wheelchair transfers in frail elderly people living at home and to determine the differences associated with different methods of transfer. Methods: Cardiovascular responses during such transfers were measured in 22 frail elderly subjects (mean age, 79.7 years) and 11 healthy elderly subjects (mean age, 79.8 years) living at home. The frail elderly subjects consisted of: 11 subjects who required additional help during the transfer; and 11 subjects who could perform the transfer either with some help or independently. Results: In the healthy subjects, diastolic blood pressure increased significantly 15 min after the transfer compared with the pretransfer measurement (P < 0.05). In the dependent group, there was no significant change in blood pressure after the transfer in three subjects. Only four subjects exhibited normal heart rate variability after the transfer. In the partially dependent or independent group, there was a significant increase in blood pressure just after the transfer (P < 0.05). The change in mean blood pressure in the dependent group was significantly lower than that of the partially dependent or independent group from just before the transfer to 15 min after the transfer (P < 0.05). Conclusion: These results suggest poor cardiovascular responsiveness in the ‘dependent’ subjects. In partially dependent or independent patients, independent transfers might result in cardiac overload. Blood pressure responses during bed‐to‐wheelchair transfers in frail elderly subjects living at home might differ according to the method of transfer.