The relationship between frailty and HRQoL in elderly cardiovascular patients in Phase II Cardiac Rehabilitation

Type of funding sources: None.

With an aging cardiovascular disease population, frailty is become an important prognostic factor in patients, which is associated with poor quality of life outcomes, such as fatigue, and decreased physical activity. However, the relationship between frailty and health-related quality of life (HRQOL) in elderly patients undergoing cardiac rehabilitation (CR) remains unclear.

In this study, 217 patients (mean age: 74.6 ± 5.8 years; male: 67%) were recruited who participated in early phase II CR at a university hospital between November 2015 and December 2016. As part of the CR processed, patients were asked to complete the Kihon Checklist (KCL) and 36-Item Short Form Survey (SF-36). We divided patients into three groups according to their KCL results: the frailty group (n = 81; 37%), the pre-frailty group (n = 71; 32%), and the non-frailty group (n = 65; 29%). The three groups were compared based on their basic characteristics and SF-36 scores.

Among the three groups, sex, body mass index, 6-minute walking distance (6MWD), hemoglobin level, and low-density lipoprotein cholesterol level varied significantly (p<0.05). The frailty group scored significantly lower than the other two groups on all items of the SF-36, the Physical Component Summary (PCS), and the Mental Health Component Summary (MCS) (p< 0.05). In all groups, the PCS scores were below the standardized mean scores. Interestingly, MCS score in the frailty group was below the standardized mean scores. Additionally, the significant correlations were found between the PCS and 6MWD in the non-frailty group (p=0.006, r=0.38) and pre-frailty group (p=0.002, r=0.52), but no correlation was found in the frailty group (p=0.14, r=0.22). On the other hand, there was no significant correlation between MCS score and 6MWD in all groups.

HRQOL as well as physical and mental domains declined in frail elderly patients undergoing CR, which suggests that an intervention program considering social life and daily roles is necessary.