TY - JOUR
T1 - Health-related quality of life in elderly cardiac patients undergoing cardiac rehabilitation and the association with exercise capacity
T2 - The EU-CaRE study
AU - Kjesbu, Ingunn E
AU - Sibilitz, Kirstine L
AU - Petersen, Janne
AU - Houben, Vital J G
AU - Wilhelm, Matthias
AU - Pena-Gil, Carlos
AU - Iliou, Marie Christine
AU - Zeymer, Uwe
AU - Ardissino, Diego
AU - Van 't Hof, Arnoud W J
AU - van der Velde, Astrid E
AU - de Kluiver, Ed P
AU - Prescott, Eva
N1 - © The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].
PY - 2024/11/18
Y1 - 2024/11/18
N2 - AIMS: The ability to be physically active is pivotal to the quality of life in elderly patients. This study aims to describe the association between exercise capacity and health-related quality of life (HRQoL), anxiety, and depression following an exercise-based cardiac rehabilitation (CR) programme in elderly cardiac patients.METHODS AND RESULTS: Patients aged ≥65 years with acute and chronic coronary syndrome or heart valve surgery were consecutively included from eight CR centres in seven European countries. Exercise capacity [VO2peak(mL/kg/min)] was assessed with a cardiopulmonary exercise test (97%) or a 6-min walk test. Outcome variables included HRQoL [36-item Short-Form Health Survey physical and mental component scores (PCS and MCS)], anxiety (Generalized Anxiety Disorder-7), and depression (Patient Health Questionnaire-9). Mixed models were used to address the association between baseline and the development in VO2peak, and outcome variables stratified on sex, and adjusted for baseline values, age, and CR centre. A total of 1633 patients were included (T0), 1523 (93%) completed end-of-CR assessment (T1), and 1457 (89%) were available for 1-year follow-up (T2). Women had higher percentage of predicted VO2peak but poorer scores in HRQoL, anxiety, and depression at all time points. All scores improved in both sexes at follow-up. We found significant associations between VO2peak at baseline as well as development in VO2peak and all outcome variables at T1 and T2 in men (all P < 0.001). In women, VO2peak was only associated with PCSs (P < 0.001).CONCLUSION: Improvements in exercise capacity were strongly associated with improvements in HRQoL and mental health, however, with stronger associations in men. The results highlight the importance of physical fitness for HRQol and mental health. The findings from this study might be useful to better target individual CR programmes.
AB - AIMS: The ability to be physically active is pivotal to the quality of life in elderly patients. This study aims to describe the association between exercise capacity and health-related quality of life (HRQoL), anxiety, and depression following an exercise-based cardiac rehabilitation (CR) programme in elderly cardiac patients.METHODS AND RESULTS: Patients aged ≥65 years with acute and chronic coronary syndrome or heart valve surgery were consecutively included from eight CR centres in seven European countries. Exercise capacity [VO2peak(mL/kg/min)] was assessed with a cardiopulmonary exercise test (97%) or a 6-min walk test. Outcome variables included HRQoL [36-item Short-Form Health Survey physical and mental component scores (PCS and MCS)], anxiety (Generalized Anxiety Disorder-7), and depression (Patient Health Questionnaire-9). Mixed models were used to address the association between baseline and the development in VO2peak, and outcome variables stratified on sex, and adjusted for baseline values, age, and CR centre. A total of 1633 patients were included (T0), 1523 (93%) completed end-of-CR assessment (T1), and 1457 (89%) were available for 1-year follow-up (T2). Women had higher percentage of predicted VO2peak but poorer scores in HRQoL, anxiety, and depression at all time points. All scores improved in both sexes at follow-up. We found significant associations between VO2peak at baseline as well as development in VO2peak and all outcome variables at T1 and T2 in men (all P < 0.001). In women, VO2peak was only associated with PCSs (P < 0.001).CONCLUSION: Improvements in exercise capacity were strongly associated with improvements in HRQoL and mental health, however, with stronger associations in men. The results highlight the importance of physical fitness for HRQol and mental health. The findings from this study might be useful to better target individual CR programmes.
KW - Age Factors
KW - Aged
KW - Aged, 80 and over
KW - Anxiety/psychology
KW - Cardiac Rehabilitation/methods
KW - Depression/psychology
KW - Europe
KW - Exercise Test
KW - Exercise Therapy/methods
KW - Exercise Tolerance
KW - Female
KW - Heart Diseases/rehabilitation
KW - Humans
KW - Male
KW - Mental Health
KW - Quality of Life
KW - Recovery of Function
KW - Time Factors
KW - Treatment Outcome
UR - http://www.scopus.com/inward/record.url?scp=85209640918&partnerID=8YFLogxK
U2 - 10.1093/eurjpc/zwae195
DO - 10.1093/eurjpc/zwae195
M3 - Journal article
C2 - 38838210
SN - 2047-4873
VL - 31
SP - 1950
EP - 1957
JO - European Journal of Preventive Cardiology
JF - European Journal of Preventive Cardiology
IS - 16
ER -