title: Outcomes of Pulmonary Rehabilitation for COPD in Older Patients: A Comparative Study.
abstract: Pulmonary rehabilitation (PR) is established as an effective intervention in optimising function and quality of life in patients with chronic obstructive pulmonary disease (COPD). However, there are very limited data on the effectiveness of PR in older patients with COPD. We reviewed all patients attending an 8-week outpatient programme. Patients were divided into two groups; Group A (n = 202), below 70 years, and Group B (n = 122), above 70 years of age. Outcomes in both patient subgroups were compared using FEV1, Incremental Shuttle Walk Test (ISWT), Endurance Shuttle Walk Test (ESWT), Grip Strength, St. George's Respiratory Questionnaire (SGRQ), Hospital Anxiety and Depression Score (HADS), and COPD Assessment Test (CAT) score. Statistical analysis was conducted using Mann-Whitney non-parametric testing and chi-square testing for comparison of clinically relevant improvements between groups. There was no significant difference in PR outcomes between Group A and Group B using absolute values. Mean changes in ISWT for Groups A and B 39.7 m vs. 32.8 m (p = 0.63), respectively, SGRQ -2.5 vs. -2.8 (p = 0.95), HADS anxiety score -0.83 vs. -0.57 (p = 0.43) and HADS depression score -0.69 vs. -0.39 (p = 0.48), respectively. There was no difference in the proportion of patients who achieved the minimal clinically significant improvement in Group A versus Group B for parameters ISWT (38.6% vs 42.7%), SGRQ (27.8% vs 21.3%), and HADS total score (20.5% vs 28.1%). These data suggest that benefits of PR in COPD are not age dependent. Age should not be a barrier to enrolling patients with COPD in PR programmes.
authors.affiliation: a Medical Education Unit, University College Cork , Cork , Ireland.
authors.forename: Deirdre
authors.initials: D
authors.lastname: Bennett
authors.affiliation: b Department of Respiratory Medicine , Cork University Hospital , Cork , Ireland.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Bowen
authors.affiliation: c Department of Medicine , University College Cork , Cork , Ireland.
authors.forename: Padriac
authors.initials: P
authors.lastname: McCarthy
authors.affiliation: b Department of Respiratory Medicine , Cork University Hospital , Cork , Ireland.
authors.forename: Abi
authors.initials: A
authors.lastname: Subramaniam
authors.affiliation: c Department of Medicine , University College Cork , Cork , Ireland.|d Department of Medicine for the Elderly , Cork University Hospital , Cork , Ireland.
authors.forename: Michael
authors.initials: M
authors.lastname: O'Connor
authors.affiliation: b Department of Respiratory Medicine , Cork University Hospital , Cork , Ireland.|c Department of Medicine , University College Cork , Cork , Ireland.
authors.forename: Mike T
authors.initials: MT
authors.lastname: Henry
mesh_terms: D000367:Age Factors; D000368:Aged; D001007:Anxiety / Q000209:etiology; D003863:Depression / Q000209:etiology; D005541:Forced Expiratory Volume; D018737:Hand Strength; D006801:Humans; D008875:Middle Aged; D000071081:Minimal Clinically Important Difference; D011569:Psychiatric Status Rating Scales; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D000070857:Walk Test
keywords: COPD; Pulmonary rehabilitation; exercise; older patients