The impact of cardiac rehabilitation for older adults with heart failure who underwent invasive cardiac treatment eligible for long-term care needs certification: A retrospective cohort study

IF 1.8 Q2 MEDICINE, GENERAL & INTERNAL

Journal of General and Family Medicine Pub Date : 2023-11-29 DOI:10.1002/jgf2.663

Masaru Asai MSc, PhD, Yuji Nishizaki MD, MPH, PhD, Shuko Nojiri PhD, Sachiko Nakagami, Soshi Dohmae, Yukio Suzuki MD, PhD, Taiga Chiba, Miho Yokoyama MD, Tohru Minamino MD, PhD

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Abstract

Background

This study aimed to assess the usefulness of cardiac rehabilitation (CR) for older adults with heart failure (HF) who need nursing care and investigate the effect of CR on cognitive function (CF) and basic activities of daily living (BADL).

Methods

This was a retrospective cohort study. The study included older adults with HF eligible for long-term care insurance in fiscal year 2014 (FY2014) as the baseline and followed them up until March 2018. Patients were divided into two groups, CR (+) and CR (−), and the changes in their CF and BADL scores over time for 3 years were investigated.

Results

Of the 765 patients included in the study, 36.5% performed CR. BADL scores in the CR (+) and CR (−) groups (mean (SE)) were 5.81 (0.26) vs. 5.87 (0.20) in FY2014, 5.6 (0.28) vs. 5.92 (0.21) in FY2015, 5.72 (0.31) vs. 6.15 (0.22) in FY2016, and 5.64 (0.33) vs. 6.40 (0.25) in FY2017, respectively. BADL scores worsened over time in the CR (−) group but had a trend to inhibit decline in the CR (+) group, and a significant difference was observed between both groups (p = 0.04). Multivariate analysis showed a significant difference in CR as a factor suppressing ADL decline after 1 year (adjusted odds ratios: 0.54, 95% confidence intervals: 0.36–0.82; p = 0.004). However, no significant difference in the CF scores was observed.

Conclusion

CR for older adults with HF eligible for long-term care needs certification does not affect CF and may suppress ADL decline.

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心脏康复对接受侵入性心脏治疗并符合长期护理需求认证条件的心力衰竭老年人的影响：回顾性队列研究

本研究旨在评估心脏康复（CR）对需要护理的心力衰竭（HF）老年人的作用，并调查心脏康复对认知功能（CF）和基本日常生活活动（BADL）的影响。研究以2014财年（FY2014）符合长期护理保险资格的心房颤动老年人为基线，随访至2018年3月。患者被分为两组，即 CR（+）组和 CR（-）组，并调查了他们的 CF 和 BADL 评分随时间推移的变化，为期 3 年。CR (+) 组和 CR (-) 组的 BADL 评分（平均值（SE））分别为：2014 财年 5.81 (0.26) vs. 5.87 (0.20)，2015 财年 5.6 (0.28) vs. 5.92 (0.21)，2016 财年 5.72 (0.31) vs. 6.15 (0.22)，2017 财年 5.64 (0.33) vs. 6.40 (0.25)。随着时间的推移，CR（-）组的 BADL 评分有所下降，但 CR（+）组的 BADL 评分有抑制下降的趋势，两组之间存在显著差异（P = 0.04）。多变量分析表明，1 年后，CR 作为抑制 ADL 下降的因素有显著差异（调整后的几率：0.54，95% 置信区间：0.36-0.82；P = 0.004）。符合长期护理需求认证条件的高血压老年人的 CR 不会影响 CF，但可能会抑制 ADL 的下降。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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