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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
The Role of Cardiovascular Rehabilitation in the Elderly Patient
Pablo Díez-Villanueva1, César Jiménez-Méndez2, Héctor García Pardo3
1Cardiology Department, Hospital Universitario La Princesa, Madrid, Spain.
Insights
Cardiac rehabilitation (CR) significantly benefits elderly patients with cardiovascular disease, improving outcomes and quality of life. This review highlights CR
Area of Science:
- Gerontology
- Cardiology
- Public Health
Background:
- Cardiovascular disease (CVD) is a primary cause of death and disability in older adults.
- Common CVDs include coronary artery disease, heart failure, and peripheral artery disease.
- Elderly patients often present with comorbidities and frailty, complicating CVD management.
Purpose of the Study:
- To review the benefits of cardiac rehabilitation (CR) in the elderly population with established CVD.
- To propose a framework for personalized CR strategies in older adults.
- To emphasize the importance of addressing frailty in elderly CVD patients.
Main Methods:
- Systematic review of existing literature on CR for elderly patients.
- Analysis of CR's impact on cardiovascular outcomes, functional independence, and quality of life.
- Examination of CR's role in managing cardiovascular risk factors and geriatric syndromes.
Main Results:
- CR is associated with significant cardiovascular benefits in older adults.
- CR improves functional independence and quality of life.
- Elderly patients are under-referred to CR compared to younger individuals.
Conclusions:
- CR offers substantial benefits for elderly patients with cardiovascular disease.
- Personalized CR programs, integrating geriatric care, are crucial.
- Addressing frailty and comorbidities enhances CR effectiveness in older populations.
Background:
Cardiovascular disease is the leading cause of morbidity and mortality in the elderly population. Coronary artery disease, heart failure, and peripheral artery disease constitute the prevailing conditions. Cardiac rehabilitation (CR) represents a cornerstone in the secondary prevention of cardiovascular disease, since it has been associated with significant cardiovascular benefits in the above-mentioned conditions, by significantly reducing cardiovascular outcomes and improving functional independence and quality of life. Besides, CR offers the background for optimizing the control of cardiovascular risk factors and implementing physical exercise, also providing psychological and social support.
Summary:
The prevalence of cardiovascular disease increases with age, associating high morbidity and mortality. In addition, comorbidities, frailty, and other geriatric conditions, entities that also entail poor prognosis, are often present in elderly patients. Indeed, frailty is recommended to be systematically addressed in elderly patients with cardiovascular disease, and there is growing evidence regarding the benefits of CR programs in this setting, also associated with lower adverse events during follow-up. However, elderly patients are less often referred to CR after a cardiovascular event when compared to their younger counterparts. In this review, we summarized the benefits of CR programs in the elderly population with established cardiovascular disease, proposing a comprehensive framework that integrates personalized care strategies.
Key Messages:
Cardiovascular disease is the leading cause of morbimortality, especially in the elderly. The management of cardiovascular disease in elderly patients poses unique challenges, since they represent a heterogeneous group and evidence is low. CR can provide significant benefits in older patients, encompassing physical training and specific management of geriatric syndromes.
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