DETERMINANTS OF EXERCISE TOLERANCE AFTER ACUTE MYOCARDIAL INFARCTION IN OLDER PERSONS.
Gerontology and Geriatric Medicine, University of Florence, Florence, Italy.
[Sponsor; N. Oldridge, FACSM].
Although all randomized controlled trials [RCT] of cardiac rehabilitation [CR] after myocardial infarction [MI] have systematically excluded older persons, the age-related reduction in exercise tolerance [TWC, Kg.m] has been confirmed in observational and controlled, but not randomized, studies. We designed a RCT to compare the efficacy of 8-weeks of CR in middle-aged [45-65 years; n=89; mean age=57 years], elderly [66-75 years; n=90; mean age 70 years], and old-old [76-85 years; n=86; mean age=80 years]. In this analysis, we report on the factors which are independent determinants of baseline TWC. Baseline TWC was lower [p<0.001] in the old-old patients [1634 Kg.m] than either the elderly [2748 Kg.m] or the middle-age patients [4642 Kg.m]. With univariate analysis, a series of variables were identified as potential confounders between baseline TWC and age. Using backward stepwise regression analysis, age, gender, body surface area, intensity of physical activity pre-MI, and depressive symptom scores were independently related to TWC [R2=0.43; p<0.001] with age explaining 70% of the observed variance. We calculated the average decrement in TWC per decade between 45 and 85 years of age as 1285 Kg.m/decade in the unadjusted model and as 922 Kg.m/decade in the final adjusted model. These data confirm the previously reported strong association between age and TWC. Other variables included in the model provide information that is both relevant and important in optimizing care in the early stages of recovery and for making decisions about referral to CR for older post-MI patients.
Supported by a grant from the Italian National Research Council [SP5]
American College of Sports Medicine; 46th Annual Meeting; Washington State; Convention & Trade Center; June 2-5, 1999
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B-48 SLIDE EXER EVAUA IN PERSONS WITH & WITHOUT CARDIOVASCULAR DISEASE© 1999 Lippincott Williams & Wilkins, Inc.