ORIGINAL ARTICLE   Free access

European Journal of Physical and Rehabilitation Medicine 2020 April;56(2):197-205

DOI: 10.23736/S1973-9087.20.05970-5

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Psychophysical health of elderly inpatients in cardiac rehabilitation: a retrospective cohort study

Gianluigi BALESTRONI ¹, Anna PANZERI ¹ ✉, Pierangela OMARINI ¹, Paola CERUTTI ¹, Daniela SACCO ¹, Andrea GIORDANO ², Massimo PISTONO ³, Klara KOMICI ⁴, Silvia ROSSI FERRARIO ¹

¹ Unit of Psychology and Neuropsychology, Maugeri Scientific Institutes IRCCS, Veruno, Novara, Italy; ² Unit of Bioengineering, Maugeri Scientific Institutes IRCCS, Veruno, Novara, Italy; ³ Department of Cardiology, Maugeri Scientific Institutes IRCCS, Veruno, Novara, Italy; ⁴ Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy

BACKGROUND: Elderlies in cardiac rehabilitation show a particular frailty due to specific aging issues, thus specific professional psychophysical care is required.
AIM: This study aimed at evaluating the effect of a cardiac rehabilitation program enhanced with psychological support on the psychophysical health of elderly subjects aged ≥75. Moreover, the association of psychophysical conditions with the long-term post-discharge course of medical events was examined.
DESIGN: This retrospective cohort study was conducted on elderly patients aged ≥75 admitted from 2015 to 2019 to a cardiac rehabilitation program including psychological support.
SETTING: The cardiac ward and the psychology unit of a post-acute clinical rehabilitation Institute.
POPULATION: A total of 523 elderly inpatients (44% females), aged ≥75 years (mean 79.7±3.46 years), admitted to a cardiac rehabilitation ward due to heart disease.
METHODS: Psychological and functional variables such as depression, quality of life, and Barthel Index were measured at hospitalization and at discharge. The medical events after discharge such as emergency department accesses and rehospitalizations were registered.
RESULTS: Cardiac rehabilitation showed significant improvements both in elderlies’ psychological and physical health. Higher depression levels predicted a worse post-discharge course. Patients who received psychological intervention accessed emergency department and were re-hospitalized significantly later than the others.
CONCLUSIONS: Cardiac comprehensive rehabilitation can significantly improve the psycho-physical health of elderly subjects aged ≥75 who benefit of psychological support. Psychological support can enhance the psychophysical health of great elder inpatients in cardiac rehabilitation.
CLINICAL REHABILITATION IMPACT: Given the associations with short and long-term outcomes, health professionals should take care of the psychological conditions of elderlies (e.g., depression) by integrating psychological interventions in cardiac rehabilitation in order to promote the elderlies’ psychophysical conditions, quality of life, as well as more favorable medical outcomes.

KEY WORDS: Aged; Cardiac rehabilitation; Mental Health; Health; Psychotherapy