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

BackgroundThis 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).MethodsThis 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.ResultsOf 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.ConclusionCR for older adults with HF eligible for long-term care needs certification does not affect CF and may suppress ADL decline. We investigated the effect of cardiac rehabilitation (CR) in older adults with heart failure who underwent invasive cardiac treatment eligible for long-term care needs certification. The basic activities of daily living (BADL) score worsened over time in the CR (-) group but had a trend to inhibit the decline in the CR (+) group. A significant difference in yearly changes in BADL scores was observed between the CR (+) and CR (-) groups.image