Do Older Patients Need a Different Approach to Rehabilitation After Coronary Revascularization?

Despite the increasing size of the population over the age of 65 years and increasing use of coronary revascularization procedures in the elderly population in the developed countries of the world, very limited information is available about the rehabilitative needs of people in this age group. We conducted a study to compare the baseline characteristics, before scheduled coronary revascularization, of patients over and under 65 years of age, in order to determine whether a need exists for a different approach in the rehabilitation of elderly patients. One hundred eighty-two consecutive patients with angina pectoris, who were scheduled to undergo isolated coronary artery bypass grafting or percutaneous transluminal coronary angioplasty for the first time, were examined at the time of coronary angiography with respect to sociodemographic data, extent of coronary artery disease, risk-factor levels, and psychosocial status with the help of self-administered questionnaires, including the Nottingham Health Profile. Eight-four patients (52 male and 32 female) aged 65 years and over were compared to 98 (84 male and 14 female) patients younger than 65 years. Three-vessel disease was significantly more frequent (73% vs 44%, P equals 0.001) in the older age group than in the younger. Risk-factor levels were similar in both age groups. With regard to quality of life, the elderly patients, as expected, experienced less impairment of function in their work (since 93% were retired) and more limitation in their mobility. Otherwise, there were no significant differences between the two age groups in the parameters examined. We conclude from this baseline study that elderly patients do not need a different approach to rehabilitation, provided there is a flexible, patient-specific approach to multifactorial intervention after coronary revascularization.