Leonardo Bencivenga1,2, Grazia Daniela Femminella3, Pasquale Ambrosino4, Quirino Bosco4, Claudio De Lucia4, Giovanni Perrotta3,4, Roberto Formisano4, Klara Komici5, Dino Franco Vitale6, Nicola Ferrara3,5, Mauro Maniscalco4, Francesco Cacciatore3, Antimo Papa7, Giuseppe Rengo8,9. 1. Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy. 2. Gérontopôle de Toulouse, Institut du Vieillissement, CHU de Toulouse, Toulouse, France. 3. Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy. 4. Cardiac Rehabilitation Unit, Istituti Clinici Scientifici Maugeri IRCCS, Scientific Institute of Telese Terme, Bagni Vecchi, 1, 82037, Telese Terme, Italy. 5. Department of Medicine and Health Sciences, University of Molise, 86100, Campobasso, Italy. 6. Clinica San Michele, Via Appia 187, 81024, Maddaloni, CE, Italy. 7. Cardiac Rehabilitation Unit, Istituti Clinici Scientifici Maugeri IRCCS, Scientific Institute of Telese Terme, Bagni Vecchi, 1, 82037, Telese Terme, Italy. antimo.papa@icsmaugeri.it. 8. Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy. giuseppe.rengo@unina.it. 9. Cardiac Rehabilitation Unit, Istituti Clinici Scientifici Maugeri IRCCS, Scientific Institute of Telese Terme, Bagni Vecchi, 1, 82037, Telese Terme, Italy. giuseppe.rengo@unina.it.
Abstract
BACKGROUND: Cardiovascular diseases are the leading cause of mortality, morbidity, and disability in the world, especially in the older adults. A relevant proportion of patients admitted to Cardiac Rehabilitation (CR) may suffer from frailty, a complex geriatric syndrome with multifactorial aetiology. AIMS: The hypothesis underlying the study is that frailty complicates the management of older patients undergoing CR. The main objective is, therefore, to determine the relationship between frailty and CR outcomes in hospitalized older adults. METHODS: The participants have been recruited among patients aged ≥ 65 years admitted at the hospital for CR. A Comprehensive Geriatric Assessment (CGA)-based Frailty Index (FI) was created following a standard procedure. The outcome was measured as the ratio between 6-min walk test (6MWT) distance at the end of CR and normal predicted values for a healthy adult of same age and gender, according to reference equations. RESULTS: The study population consisted of 559 elderly patients, 387 males (69.2%), with age of 72 (69-76) years. The most frequent diagnosis at admission was ischaemic heart disease (231, 41.5%) and overall 6MWT ratio was 0.62 ± 0.21. At the multivariable regression analysis, gender, diagnosis and FI were significantly and independently associated with 6MWT ratio (p ≤ 0.0001, p ≤ 0.001 and p ≤ 0.0001, respectively), while no significant association emerged for age. CONCLUSION: FI resulted independently correlated to 6MWT ratio in a population of older patients undergoing in-hospital CR programs. Frailty is a multifactorial geriatric syndrome whose assessment is essential for prognostic evaluation of older patients, also in CR clinical setting.
BACKGROUND: Cardiovascular diseases are the leading cause of mortality, morbidity, and disability in the world, especially in the older adults. A relevant proportion of patients admitted to Cardiac Rehabilitation (CR) may suffer from frailty, a complex geriatric syndrome with multifactorial aetiology. AIMS: The hypothesis underlying the study is that frailty complicates the management of older patients undergoing CR. The main objective is, therefore, to determine the relationship between frailty and CR outcomes in hospitalized older adults. METHODS: The participants have been recruited among patients aged ≥ 65 years admitted at the hospital for CR. A Comprehensive Geriatric Assessment (CGA)-based Frailty Index (FI) was created following a standard procedure. The outcome was measured as the ratio between 6-min walk test (6MWT) distance at the end of CR and normal predicted values for a healthy adult of same age and gender, according to reference equations. RESULTS: The study population consisted of 559 elderly patients, 387 males (69.2%), with age of 72 (69-76) years. The most frequent diagnosis at admission was ischaemic heart disease (231, 41.5%) and overall 6MWT ratio was 0.62 ± 0.21. At the multivariable regression analysis, gender, diagnosis and FI were significantly and independently associated with 6MWT ratio (p ≤ 0.0001, p ≤ 0.001 and p ≤ 0.0001, respectively), while no significant association emerged for age. CONCLUSION: FI resulted independently correlated to 6MWT ratio in a population of older patients undergoing in-hospital CR programs. Frailty is a multifactorial geriatric syndrome whose assessment is essential for prognostic evaluation of older patients, also in CR clinical setting.
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