PULMONARY REHABILITATION IMPROVES EXERCISE CAPACITY IN OLDER ELDERLY PATIENTS WITH COPD

Pulmonary rehabilitation has been shown to improve exercise capacity i n patients with COPD. It has been suggested that this improvement appl ies to all age groups; however, to our knowledge, the effects of pulmo nary rehabilitation on older elderly patients (greater than or equal t o 75 years of age) have not been studied. We compared changes in 12-mi n walking distance (12MD) and self-assessment scores in 47 older elder ly patients with moderate to severe COPD who completed inpatient or ou tpatient pulmonary rehabilitation with those achieved by 87 younger pa tients who participated in the same programs from 1987 to 1992. There were 28 older elderly individuals (mean +/- SEM, 78 +/- 1 years) in th e outpatient group and 56 younger patients (64 +/- 1 years). There wer e no differences between older and younger outpatients with respect to FEV(1), FEV(1)/FVC, maximum inspiratory pressure (PImax), baseline 12 MD, or baseline self-assessment score. After outpatient pulmonary reha bilitation, 12MD and self-assessment scores improved significantly in both groups. Inpatients included 19 older elderly individuals (81 +/- 1 years) who were also similar to the 31 younger inpatients (64 +/- 1 years) in FEV(1), FEV(1)/FVC, PImax, and baseline self-assessment scor e, but they tended to be more limited in terms of baseline 12MD (p=0.0 9). After inpatient pulmonary rehabilitation, significant improvements in 12MD and self-assessment were seen in both groups. We conclude tha t comprehensive outpatient and inpatient pulmonary rehabilitation prog rams are as beneficial in older elderly patients with COPD as they are in younger patients with similar lung function abnormalities. Patient s 75 years of age or older should be considered for comprehensive pulm onary rehabilitation.