The Relationship Between Health-Related Quality of Life and Frailty in Older Patients Participating in Early Phase II Cardiac Rehabilitation

Background: Frailty is a significant prognostic risk factor for cardiovascular disease and it can lead to poor quality of life due to malnutrition, fatigue, and reduced physical activity. However, few studies have investigated how frailty affects older patients participating in cardiac rehabilitation (CR) on health-related quality of life (HRQoL). Methods and Results: Between November 2015 and December 2016 at Juntendo University Hospital, 217 patients (mean age 74.6±5.8 years; males 67%) participated in CR. Patients completed self-evaluations using the 36-item Short Form Survey (SF-36) and the Kihon Checklist (KCL) at the baseline of CR. The patients were divided into 3 groups: frailty group (n=81; 37%); pre-frailty group (n=71; 33%); and non-frailty group (n=65; 30%). Based on the KCL findings, we compared demographics, clinical measures, and SF-36 scores among the 3 groups. Sex, body mass index, 6-min walking distance, hemoglobin level, and low-density lipoprotein cholesterol differed significantly among the 3 groups. All SF-36 items also showed significant group differences; the frailty group scored lower than the other 2 groups on the physical component summary and mental component summary (MCS). Furthermore, the frailty group had a lower MCS score than the average Japanese age level. Conclusions: Frail older patients undergoing CR experience significant deterioration in both physical and mental dimensions of HRQoL.