Cardiac rehabilitation in the elderly

Background Although patients greater than or equal to 65 years old account for the majority of cardiac admissions and procedures in the United States, studies of cardiac rehabilitation have traditionally focused on younger pa tients. Only recently has the effectiveness of cardiac rehabilitation in th e elderly population begun to receive more attention. Methods We present a comprehensive literature review of studies that have l ooked specifically at the effectiveness of cardiac rehabilitation in the el derly. We discuss the methodologic limitations of studies to date, compare outcomes among elderly rehabilitation patients with those of younger patien ts, and examine barriers to participation among the elderly, Results The majority of studies published to date have been small observati onal case series. Despite these limitations, these studies generally show c onsistent improvements in exercise capacity, cardiac risk factors, and qual ity-of-life parameters in elderly cardiac rehabilitation patients. These be nefits appear to be similar to those seen in younger patients. In spite of this, participation rates among the elderly are low, primarily because of l ess aggressive referral. Conclusions Although further studies are necessary, the current literature shows that cardiac rehabilitation is associated with improved outcomes afte r a cardiac event, regardless of age. However, innovative recommendation an d referral strategies are needed because few elderly patients actually enro ll.