Factors Associated With Cardiac Rehabilitation Participation in Older Adults After Myocardial Infarction: THE SILVER-AMI STUDY. Issue 2 (17th March 2022)

• Record Type: Journal Article
• Authors: Goldstein, David W.; Hajduk, Alexandra M.; Song, Xuemei; Tsang, Sui; Geda, Mary; Dodson, John A.; Forman, Daniel E.; Krumholz, Harlan; Chaudhry, Sarwat I.
• Is Part Of: Journal of cardiopulmonary rehabilitation and prevention. Volume 42:Issue 2(2022)
• Page Start: 109
• Page End: 114
• Publication Date: 2022-03-17
• Subjects: acute myocardial infarction -- cardiac rehabilitation -- functional impairments; Cardiopulmonary system -- Diseases -- Patients -- Rehabilitation -- Periodicals; Cardiopulmonary system -- Diseases -- Prevention -- Periodicals; 616.103
• DOI: 10.1097/HCR.0000000000000627
• Languages: English
• ISSNs: 1932-7501

Abstract

Abstract : This study evaluated predictors of cardiac rehabilitation (CR) utilization in a nationwide cohort of acute myocardial infarction (AMI) patients age ≥75 yr. Traditional risk factors (eg, education and coronary intervention) as well as novel factors (eg, functional and sensory impairments) were important drivers of CR use among older adults with AMI. Abstract : Purpose: Cardiac rehabilitation (CR) is a key aspect of secondary prevention following acute myocardial infarction (AMI). While there is growing evidence of unique benefits of CR in older adults, it remains underutilized. We aimed to examine specific demographic, clinical, and functional factors associated with utilization of CR among older adults hospitalized with AMI. Methods: Our project used data from the SILVER-AMI study, a nationwide prospective cohort study of patients age ≥75 yr hospitalized with AMI and followed them up for 6 mo after discharge. Extensive baseline data were collected on demographics, clinical and psychosocial factors, and functional and sensory impairments. The utilization of CR was collected by a survey at 6 mo. Backward selection was employed in a multivariable-adjusted logistic regression model to identify independent predictors of CR use. Results: Of the 2003 participants included in this analysis, 779 (39%) reported participating in CR within 6 mo of discharge. Older age, longer length of hospitalization, having ≤12 yr of education, visual impairment, cognitive impairment, and living alone were associated with decreased likelihood of CR participation; receipt of diagnostic and interventional procedures (ie, cardiac catheterization, percutaneous coronary intervention, and coronary artery bypass graft) was associated with increased likelihood of CR participation. Conclusions: Demographic and clinical factors, as well as select functional and sensory impairments common in aging, were associated with CR participation at 6 mo post-discharge in older AMI patients. These results highlight opportunities to increase CR usage among older adults and identify those at risk for not participating.