Compliance with cardiac rehabilitation in the elderly

Abstract

To evaluate the compliance of the elderly with cardiac rehabilitation (CR) after myocardial infarction, 370 consecutive patients greater than or equal to 65 years of age, admitted to our Coronary Care Unit over a period of 2 years, were examined: 48 died in the hospital, 34 were transferred to other wards and 29 were unable to perform a submaximal exercise test before discharge. Out of the remaining 259 patients, 43 began the CR and 32 completed it with a good outcome. Eleven patients interrupted the CR because of associated diseases. A social investigation was carried out on 83 of the 259 patients discharged from our ward. In addition to associated diseases and an extremely low exercise tolerance (41% of cases), the lack of participation was due to socioeconomic problems (9.5%), to lack of motivation (52.3%) and to inadequate information (38.1%). Nevertheless, 76% of patients indicated that they attained their previous way of life in a relatively short period of time. It is concluded that: CR is useful in patients who complete it; low compliance is due mainly to medical problems and lack of motivation; better information might slightly increase the compliance in our Center; most patients can, in any case, reach their previous way of life. It is debatable whether CR is advisable in old age, or should be directed towards selected groups of patients.

Efficacy of Telecardiology in improving the results of Cardiac Rehabilitation after acute myocardial infarction

“…Enrolment rates for Cardiac Rehabilitation have been reported to range from 15-59% [19]. Many services concentrate on relatively low risk, white middle aged patients, while women [20,21] and elderly are less likely to be included [22][23][24]. Poor recruitment is also related to service factors, such as the availability and accessibility of a program [25], the strength of a physician's recommendation to attend [26][27][28] and treatment by a general physician, rather than a cardiologist.…”

Early 4-Week Cardiac Rehabilitation Exercise Training in Elderly Patients After Heart Surgery

“…8,15,17,23,27 Fear of exercise and physical activities and the absence of willingness to work hard 25 are often observed in older coronary patients. 25,31 Therefore, a strict adherence to an exercise heart rate prescription is often inappropriate. 27 An appropriately designed exercise prescription and suitable modalities must be considered.…”

Cardiac Rehabilitation Referral and Attendance: Not One and the Same

“…Although factors relating to convenience (e.g., distance, availability of transportation) influence all patients' participation in cardiac rehabilitation (Ades, Waldmann, Polk, et al, 1992; Gori, Pivotti, Mase, Zucconi, & Scardi, 1984; Lemanski, 1990; Moore, 1996; Moore & Kramer, 1996), women and, particularly, elderly people are known to have more difficulty traveling to and consistently attending programs. Patients who live in rural areas may have more attendance problems because of travel difficulties; easy access to formal programs is often limited to urban areas (Cannistra et al, 1992; DeBusk, 1992; Moore).…”