Cardiac Rehabilitation in the Elderly Patients

Cardiac rehabilitation for elderly patient is a growing needs because as people age the prevalence of cardiovascular disease increase. A more vulnerable population is now present in cardiac rehabilitation because they are more likely to be frail. Frailty is considered highly prevalent and heterogeneous in its level of expression. Following hospitalization for an event such as acute coronary syndrome or heart failure decompensation, all patients, and in particular the elderly, are at increased risk of instabilization, new cardiovascular events and disability. The efficacy and safety of cardiac rehabilitation have been widely demonstrated also in the elderly patients with stable coronary heart disease or those who have undergone myocardial revascularization with percutaneous coronary intervention, coronary artery bypass graft surgery and heart failure. Cardiac rehabilitation programs are designed to enhance recovery from acute cardiovascular events and to improve both quality of life and survival by means of measure of secondary prevention–physical activity, diet, risk factors control and medical treatment optimization. Accumulating evidence has shown comparable exercise training benefits in older and younger patients. The use of cardiac rehabilitation programs in the elderly should be based on Comprehensive Geriatric Assessment in which different domains needs to be assessed with a definite rehabilitation program driven by the specific disability and not only related to disease. Special attention should be posed to frail elderly patients in whom a personalized intervention is necessary. In details will be described rehabilitation protocols for elderly based on prevalent disability status.