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15 Cardiac rehabilitation for geriatric and frail patients
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Published:August 2020
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Abstract
The progressive ageing of populations leads to a high burden of elderly patients with cardiac disease and is associated with comorbidities, cognitive/psychological deterioration, disability, social deprivation, and frailty. All these conditions complicate the clinical course of cardiac disease and worsen the outcome. Cardiac rehabilitation (CR), as a multidisciplinary intervention, improves mortality, morbidity, re-hospitalization, physical function, and quality of life in adult patients after acute cardiac events. Older patients without clinical complexity can follow a CR programme slightly different from that for middle-aged patients, mainly based on aerobic training, with similar functional improvement. CR for elderly cardiac patients with comorbidities, sarcopenia, or frailty should be based mainly on strength exercise integrated with aerobic and balance training, but the most appropriate exercise programme has yet to be defined. Future studies should test whether interventions tailored to the presence and severity of frailty are effective in improving specific outcomes, with particular reference to functional capacity, physical function, health-related quality of life (HQoL), disability, frailty, hospitalization, and institutionalization.
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