title: Frailty and cardiac rehabilitation: A call to action from the EAPC Cardiac Rehabilitation Section.
abstract: Frailty is a geriatric syndrome characterised by a vulnerability status associated with declining function of multiple physiological systems and loss of physiological reserves. Two main models of frailty have been advanced: the phenotypic model (primary frailty) or deficits accumulation model (secondary frailty), and different instruments have been proposed and validated to measure frailty. However measured, frailty correlates to medical outcomes in the elderly, and has been shown to have prognostic value for patients in different clinical settings, such as in patients with coronary artery disease, after cardiac surgery or transvalvular aortic valve replacement, in patients with chronic heart failure or after left ventricular assist device implantation. The prevalence, clinical and prognostic relevance of frailty in a cardiac rehabilitation setting has not yet been well characterised, despite the increasing frequency of elderly patients in cardiac rehabilitation, where frailty is likely to influence the onset, type and intensity of the exercise training programme and the design of tailored rehabilitative interventions for these patients. Therefore, we need to start looking for frailty in elderly patients entering cardiac rehabilitation programmes and become more familiar with some of the tools to recognise and evaluate the severity of this condition. Furthermore, we need to better understand whether exercise-based cardiac rehabilitation may change the course and the prognosis of frailty in cardiovascular patients.
authors.affiliation: 1 Department of Translational Medical Sciences, University of Naples Federico II, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Vigorito
authors.affiliation: 2 Cardiology Department Hospital Santa Marta, Centro Hospitalar Lisboa Central, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Abreu
authors.affiliation: 3 Cardiovascular Rehabilitation Unit, Le Terrazze Clinic, Cunardo, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Ambrosetti
authors.affiliation: 4 Cardiologia Riabilitativa Lancisi, AOR Ancona, Italy.
authors.forename: Romualdo
authors.initials: R
authors.lastname: Belardinelli
authors.affiliation: 5 Department of Cardiac Rehabilitation, Salvatore Maugeri Foundation, Veruno, Italy.
authors.forename: Ugo
authors.initials: U
authors.lastname: Corrà
authors.affiliation: 6 Department of General Practice, UKCRC Centre of Excellence for Public Health Research (NI), Northern Ireland, Queens University, Belfast.
authors.forename: Margaret
authors.initials: M
authors.lastname: Cupples
authors.affiliation: 7 Cardiovascular Research Laboratory, Biomedical Research Foundation Academy of Athens, Greece.
authors.forename: Constantinos H
authors.initials: CH
authors.lastname: Davos
authors.affiliation: 8 Medical University Innsbruck, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Hoefer
authors.affiliation: 9 Cardiac Rehabilitation Department, Hopital Corentin Celton-Assistance Publique Hôpitaux de Paris, France.
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Iliou
authors.affiliation: 10 Cardiology Clinic, Tiefenau Hospital and University of Bern, Switzerland.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Schmid
authors.affiliation: 11 Center of Rehabilitation Research, University of Potsdam, Germany; Department of Cardiology, Klinic am See, Rudersdorf.
authors.forename: Heinz
authors.initials: H
authors.lastname: Voeller
authors.affiliation: 12 Department of Health Sciences, University of York, UK.
authors.forename: Patrick
authors.initials: P
authors.lastname: Doherty
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000072038:Cardiac Rehabilitation / Q000009:adverse effects / Q000379:methods*; D015897:Comorbidity; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000009:adverse effects; D016330:Frail Elderly; D000073496:Frailty / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D015577:Geriatric Assessment; D006331:Heart Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: Frailty; cardiac rehabilitation; elderly