Pulmonary rehabilitation improves functional capacity in patients 80 years of age or older

There is limited evidence that pulmonary rehabilitation improves exercise capacity in older patients with chronic respiratory disease. The objective of the present study was to determine whether patients 80 years of age or older gain similar benefits from pulmonary rehabilitation as do younger patients.

Outcomes were compared in 230 consecutive inpatients with moderate to severe lung disease who participated in a comprehensive pulmonary rehabilitation program during a one-year period. Outcomes included 6 min walk test distance (6MWT), the number of stairs completed in 2 min (2MST), Borg dyspnea scores after exertion and objective functional scores.

There were no differences between older (80 to 91 years, n=43) and younger patients (n=187) with respect to sex, forced expiratory volume in 1 s (mean 0.77 L versus 0.72 L) or number of chronic medical diagnoses (2.4 versus 2.7). Older patients were less frequently survivors of mechanical ventilation (2.3% versus 16%). Baseline 6MWT (133 m versus 144 m; P=0.48) and 2MST (5.2 laps versus 6.5 laps; P=0.067) were similar but global function was lower (85 versus 89; P=0.040) in older patients than in younger patients, respectively. After pulmonary rehabilitation, all outcomes improved significantly regardless of age (all before-after comparisons P<0.0001). Younger patients improved with a higher discharge 6MWT (231 m versus 185 m; P=0.004) and similar discharge 2MST (9.3 laps versus 7.9 laps; P=0.070) compared with older patients. Global function at discharge remained lower in older patients than younger patients (91 versus 94; P=0.002). The duration of rehabilitation and length of stay were similar between the two groups.

A comprehensive inpatient pulmonary rehabilitation program is beneficial in selected patients 80 years of age or older.