Introduction:The purpose of cardiac
rehabilitation is to improve the effects of aging and maintain a good quality
of life for older individuals. This study aims to assess how cardiac rehabilitation
affects the autonomy and quality of life of older adults. Patients and
Method: This was a longitudinal, descriptive and comparative
before-and-after cardiovascular rehabilitation study conducted over a two-year
period from January 2019 to December 2021. This study was conducted at four
cardiac rehabilitation units in Dakar: the Aristide Le Dantec Hospital (HALD),
National Dalal Jamm Hospital, and the General Idrissa Pouye Hospital (HOGIP). We
compared the degree of autonomy, dependence and quality of life of subjects
aged over 65 before and after the cardiac rehabilitation program using the Katz
index, the Lowton index and the SF12 quality-of-life questionnaire. Results: Over a two-year period, a total of 345 patients had benefited from a complete
cardiovascular rehabilitation program in the four cardiovascular rehabilitation
units in Dakar, and 86 patients, or 24.92% of the population, were at least 65
years old. The patients were predominantly male (sex ratio M/F = 4.73). The
mean age was 70.35 ± 4.55 years for men and 69.27 ± 4.59 years for women. The
main pathology motivating cardiac rehabilitation was ischemic heart disease,
which was found in 73 patients (84.88%). Initial assessment revealed exertional
dyspnea in 35 patients (40.69%), followed by residual exertional angina in 21
patients (4.41%). Mean functional capacity increased from 5.81 ± 2.38 Mets in
pre-cardiac rehabilitation to 8.68 ± 2.28 Mets in post-cardiac rehabilitation
(p < 0.001). The mean distance covered in the 6-minute walk test increased
from 330.42 ± 170.50m in pre-cardiac rehabilitation to 524 ± 98.54m in post-cardiac rehabilitation (p = 0.119). The
Lowton dependency index in pre-cardiac rehabilitation was 44.18% versus 36.04%
in post-cardiac rehabilitation (p = 0.0156). The mental quality of life score
was 42.15 ± 10.27 in pre-cardiac rehabilitation versus 52.94 ± 10.86 in
post-cardiac rehabilitation (p < 0.001). Conclusion: This study
demonstrates the effectiveness of the cardiac rehabilitation program in elderly
subjects. In fact, this well-managed, well-structured and well-supervised
program enables this population to
References
[1]
World Health Organizations (2018) Noncommunicable Diseases (NCD) Country Profiles.
[2]
Ghannem, M., Ghannem, L., Hamdi, K., et al. (2018) Réadaptation cardiaque du sujet agé. Annales de Cardiologie et d’Angéiologie, 67, 493-501.
https://doi.org/10.1016/j.ancard.2018.09.019
[3]
Iliou, M.C. (2020) Réadaptation cardiaque: Les preuves scientifiques récentes de ses bénéfices. Archives des Maladies du Coeur et des Vaisseaux, 2020, 2-6.
https://doi.org/10.1016/j.amcp.2020.04.001
[4]
Burri, M. (1994) La personne agée et la réadaptation cardiovasculaire. Revue Medicale de la Suisse Romande, 114, 689-690.
[5]
Girerd, X., Hanon, O., Anagnostopoulos, K., et al. (2001) Evaluation de l’observance du traitement antihypertenseur par un questionnaire: Mise au point et utilisation dans un service spécialisé. Presse Médicale, 30, 1044-1048.
[6]
Katz, S., Ford, A.B., Moskowitz, R.W., et al. (1963) Studies of Illness in the Aged. The Index of ADL: A Standardized Measure of Biological and Psychosocial Function. JAMA, 185, 914-919. https://doi.org/10.1001/jama.1963.03060120024016
[7]
Lawton, M.P. and Brody, E.M. (1969) Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily Living. Gerontologist, 9, 179-186.
https://doi.org/10.1093/geront/9.3_Part_1.179
[8]
Ware, J., Kosinski, M., Turner-Bowker, D., et al. (2002) How to Score SF-12 Items. SF-12 v2: How to Score Version 2 of the SF-12. Health Survey. 29-38.
[9]
Khadanga, S., Savage, P.D. and Ades, P.A. (2019) Resistance Training for Older Adults in Cardiac Rehabilitation. Clinics in Geriatric Medicine, 35, 459-468.
https://doi.org/10.1016/j.cger.2019.07.005
[10]
Kinic, B. (2004) La réadaptation cardiaque chez les sujets agés: Etude rétrospective d’une série de 200 patients agés de 75 à 91 ans. Thèse Med. Nancy, Universite Henri Poincaré, Nancy, N°5, 152.
[11]
Ekblom, O., Cider, A., Hambraeus, K., et al. (2022) Participation in Exercise-Based Cardiac Rehabilitation Is Related to Reduced Total Mortality in both Men and Women: Results from the SWEDEHEART Registry. European Journal of Preventive Cardiology, 29, 485-492. https://doi.org/10.1093/eurjpc/zwab083
[12]
Pavy, B., Tisseau, A. and Caillon, M. (2011) Le patient coronarien six mois après la réadaptation cardiaque: Recherche sur l’évaluation de la réadaptation (étude RER). Annales de Cardiologie et d’angeiologie, 5, 252-258.
https://doi.org/10.1016/j.ancard.2011.08.004
[13]
Minvielle, C., Corré, J. and Douard, H. (2017) Barriers to Prescription of Cardiac Rehabilitation after Acute Myocardial Infarction in France. Archives of Cardiovascular Diseases Supplements, 9, 100.
https://doi.org/10.1016/S1878-6480(17)30298-7
[14]
Samayoa, L., Grace, S.L., Gravely, S., et al. (2014) Sex Differences in Cardiac Rehabilitation Enrollment: A Meta-Analysis. Canadian Journal of Cardiology, 30, 793-800. https://doi.org/10.1016/j.cjca.2013.11.007
[15]
Lavie, C.J. and Milani, R.V. (2001) Benefits of Cardiac Rehabilitation and Exercise Training Programs in Elderly Coronary Patients. The American Journal of Geriatric Cardiology, 10, 323-327. https://doi.org/10.1111/j.1076-7460.2001.00636.x
[16]
Pavy, B., Iliou, M.C., Vergès, et al. (2011) Recommandations du Groupe Exercice Réadaptation Sport (GERS) de la Société Francaise De Cardiologie concernant la pratique de la réadaptation cardiovasculaire chez l’adulte.
[17]
Bounhoure, J.P. (1999) Les effets du vieillissement sur le système cardio-vasculaire. éditions Frison-Roche, Paris, 45.
[18]
Ghannem, M. (2018) Paris manuel pratique de prévention et de réadaptation cardiovasculaire. éditions Frison-Roche, Paris, 312-325.
[19]
Paneroni, M., Scalvini, S., Corrà, U., et al. (2021) The Impact of Cardiac Rehabilitation on Activities of Daily Life in Elderly Patients with Heart Failure. Frontiers in Physiology, 12, Article ID: 785501.
https://doi.org/10.3389/fphys.2021.785501
[20]
Corone, S., Dromard, N., Lacor, C., et al. (2017) Amélioration de l’état émotionnel après réadaptation cardiaque. évaluation par le POMS: Profile of Mood States. Annales de Cardiologie et d’Angéiologie, 66, 357.
https://doi.org/10.1016/j.ancard.2017.09.025
[21]
Choo, C.C., Chew, P.K.H., Lai, S.M., et al. (2018) Effect of Cardiac Rehabilitation on Quality of Life, Depression and Anxiety in Asian Patients. International Journal of Environmental Research and Public Health, 15, Article No. 1095.
https://doi.org/10.3390/ijerph15061095
[22]
Oasi, C., Maman, S., Baghéri, H., et al. (2008) GABI, une évaluation simplifiée et informatisée de la perte d’autonomie en gériatrie: Une étude de validation. La Presse Médicale, 37, 1195-1203. https://doi.org/10.1016/j.lpm.2007.12.013
[23]
Rubenstein, L.Z., Schairer, C., Wieland, G.D., et al. (1984) Systematic Biases in Functional Status Assessment of Elderly Adults: Effects of Different Data Sources. The Journals of Gerontology, 39, 686-691. https://doi.org/10.1093/geronj/39.6.686