Benefits of cardiac rehabilitation in the ninth-decade of life in patients with coronary heart disease

Cardiac rehabilitation programs are an important part of the comprehensive care of patients with coronary heart disease. These multidisciplinary programs, which consist of exercise training, education, and risk factor reduction have been shown to increase functional capacity,(1) improve quality of life,(2) and decrease coronary-related morbidity and mortality.(3) Given the high prevalence of coronary artery disease in those aged >70 years,(4) the elderly represent a large proportion of potential cardiac rehabilitation candidates. Studies that have assessed the effects of cardiac rehabilitation in the elderly have generally consisted of patients >65 years of age,(2,5) including both the "young old" (<75 years) and the "old old" (>75 years)-2 functionally heterogenous groups. The age-related decline in muscle mass, strength, and cardiovascular fitness is magnified with each decade so that by the ninth decade of life, sedentary patients. may have marked impairment of functional capacity(6) and hence may be at the minimum threshold of fitness required for performing activities of daily independent living. Although the octogenarian age group potentially stands to benefit from even modest improvements in functional capacity that are achievable with cardiac rehabilitation, little is known about the effects of exercise training and rehabilitation in this age group. This study assesses the safety and efficacy of cardiac rehabilitation in patients greater than or equal to80 years of age.