Abstract
Background: Cardiac rehabilitation is a mainstay treatment for patients experiencing an adverse cardiovascular event. Heart disease is important in frailty, but the impact of cardiac rehabilitation on frailty is unclear. Methods: Patients were referred to a 12-week group-based exercise and education cardiac rehabilitation program performed twice weekly. Frailty was measured with the use of a 25-item accumulation of deficits frailty index (range 0-1; higher values indicate greater frailty) at cardiac rehabilitation admission and completion. Patients were categorized by the degree of frailty in 0.1 increments. Results: Of the 4004 patients who enrolled, 2322 (58.0%) completed cardiac rehabilitation with complete data at admission and completion. There were 414 (17.8%), 642 (27.6%), 690 (29.7%), 401 (17.3%), and 175 (7.5%) patients with admission frailty levels of < 0.20, 0.20-0.30, 0.30-0.40, 0.40-0.50, and > 0.50, respectively. Frailty levels improved from cardiac rehabilitation admission (mean 0.34 [95% CI 0.32-0.35]) to completion (0.26 [0.25-0.28]) for those who completed the program (P < 0.001). After adjusting for age, sex, and number of exercise sessions attended, frailty improved in all frailty groups by mean differences of 0.03 (0.02-0.03), 0.05 (0.05-0.06), 0.08 (0.08-0.09), 0.10 (0.09-0.11), and 0.11 (0.10-0.13) in the < 0.20, 0.20-0.30, 0.30-0.40, 0.40-0.50, and > 0.50 frailty groups, respectively. The minimal improvement in frailty scores (≥ 0.03 reduction) was achieved by 48%, 65%, 72%, 76%, and 79% of patients in the the 5 frailty groups, respectively. Conclusions: Although higher frailty levels were associated with cardiac rehabilitation drop-out, finishing the program was related to improving frailty levels, especially in patients who were the frailest.
| Original language | English |
|---|---|
| Pages (from-to) | 482-489 |
| Number of pages | 8 |
| Journal | Canadian Journal of Cardiology |
| Volume | 36 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Apr 2020 |
Bibliographical note
Funding Information:D.S.K was supported by a Canadian Institutes of Health Research Postdoctoral Fellowship, an Izaak Walton Killam Postdoctoral Fellowship, and a Dalhousie University Internal Medicine Research Foundation Internal Research Fellowship.
Funding Information:
N.G. has research grants from Pfizer Canada . K.R. is President and Chief Science Officer of DGI Clinical, which in the past 5 years has had contracts with pharmaceutical and device manufacturers (Baxter, Baxalta, Shire, Hollister, Nutricia, Roche, Otsuka) on individualized outcome measurement; in 2017 he attended an advisory board meeting with Lundbeck; otherwise any personal fees were for invited guest lectures and academic symposia, received directly from event organizers, chiefly for presentations on frailty; and he is Associate Director of the Canadian Consortium on Neurodegeneration in Aging, which is funded by the Canadian Institutes of Health Research with additional funding from the Alzheimer Society of Canada and several other charities, as well as, in its first phase (2013-2018), from Pfizer Canada and Sanofi Canada . The other authors have no conflicts of interest to disclose.
Publisher Copyright:
© 2019 Canadian Cardiovascular Society
ASJC Scopus Subject Areas
- Cardiology and Cardiovascular Medicine