Physical and Psychological Effectiveness of Cardiac Rehabilitation: Age Is Not a Limiting Factor!

Background: There is little data regarding the impact of patient age on the physical and psychological effectiveness of cardiac rehabilitation (CR). The aim of the present study was therefore to compare the effects of an exercise-based CR program on physical and psychological parameters in young, old, and very old patients. We also aimed to identify the features that best predicted CR outcome.

Methods: A total of 733 patients were divided into 3 subgroups: YOUNG (< 65 years old), OLD (between 65 and 80 years old), and VERY OLD (≥ 80 years old). Physical variables such as peak workload and estimated peak VO as well as psychological variables such as scores of anxiety and depression were evaluated for all patients before and after CR.

Results: Performance in all tests and scores for all questionnaires were significantly improved in all patients (P < 0.05). Age was significantly correlated with all the initial values (P < 0.05) but not with post-CR values. In addition, lower initial values of peak workload were associated with larger post-CR improvements irrespective of age. However, higher pre-CR anxiety and depression scores were associated with greater post-CR increases in physical performance in YOUNG and OLD patients, respectively.

Conclusions: CR induced significant improvements of physical and psychological parameters for all patient groups. More interestingly, our results suggest that patients with the greatest physical impairments at baseline would benefit the most from CR, whatever their age. However, the value of initial mental state as a predictor of post-CR improvement depends on the age of the patient.