Psychology Unit, ICS Maugeri IRCCS Institute of Montescano.
Department of Cardiac Respiratory Rehabilitation, ICS Maugeri IRCCS Institute of Tradate (VA).
Monaldi Arch Chest Dis. 2022 Dec 1;93(4). doi: 10.4081/monaldi.2022.2447.
Chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) are two clinical conditions often associated with cognitive dysfunctions, psychological distress, poor quality of life (QoL), and functional worsening. In addition, since patients suffering from these conditions are often older adults, frailty syndrome represents a further and important issue to be investigated. The present preliminary study aimed to perform a multidimensional assessment of CHF and/or COPD older patients (age ≥65) undergoing cardiac or pulmonary rehabilitation. The characteristics of the included patients (30 CHF and 30 COPD) resulted almost similar, except for the COPD patients' longer duration of illness and better performances in Addenbrooke's cognitive examination III subtests and short physical performance battery (SPPB). No significant differences were found in the frailty evaluation, but a consistent number of patients resulted to be frail (CHF=36.7% vs COPD=26.6%). After the rehabilitation program, a significant improvement was found in the whole sample concerning the executive functions (14.34±2.49 vs 15.62±2.22, p=0.001), quality of life (58.77±18.87 vs 65.82±18.45, p=0.003), depressive and anxious symptoms (6.27±4.21 vs 3.77±3.39, p=0.001 and 5.17±3.40 vs 3.38±3.21, p=0.001), frailty status [4.00 (3.00,5.00) vs 3.00 (3.00,5.00) p=0.035] and functional exercise abilities [SPPB, 7.40±3.10 vs 9.51±3.67, p=0.0002; timed up and go test, 14.62±4.90 vs 11.97±4.51, p<0.0001; 6-minute walking test, 353.85±127.62 vs 392.59±123.14, p=0.0002]. Preliminary results showed a substantial homogeneity of CHF and COPD older patients' cognitive, psychosocial, frailty, and functional characteristics. Nevertheless, the specific rehabilitation intervention appears promising in both clinical populations. This trial has been registered with the ClinicalTrials.gov, NCT05230927 registration number (clinicaltrials.gov/ct2/show/NCT05230927).
慢性心力衰竭（CHF）和慢性阻塞性肺疾病（COPD）是两种常伴有认知功能障碍、心理困扰、生活质量差和功能恶化的临床病症。此外，由于这些病症的患者通常是老年人，虚弱综合征是另一个需要进一步研究的重要问题。本初步研究旨在对接受心脏或肺部康复的老年 CHF 和/或 COPD 患者（年龄≥65 岁）进行多维评估。纳入患者的特征（30 例 CHF 和 30 例 COPD）几乎相似，除了 COPD 患者的疾病持续时间更长，以及在 Addenbrooke 认知测验 III 子测验和简短体能测试（SPPB）中的表现更好。在虚弱评估中未发现显著差异，但相当数量的患者表现为虚弱（CHF=36.7%比 COPD=26.6%）。在康复计划后，整个样本的执行功能（14.34±2.49 比 15.62±2.22，p=0.001）、生活质量（58.77±18.87 比 65.82±18.45，p=0.003）、抑郁和焦虑症状（6.27±4.21 比 3.77±3.39，p=0.001 和 5.17±3.40 比 3.38±3.21，p=0.001）、虚弱状态[4.00（3.00，5.00）比 3.00（3.00，5.00），p=0.035]和功能运动能力[SPPB，7.40±3.10 比 9.51±3.67，p=0.0002；计时起立行走测试，14.62±4.90 比 11.97±4.51，p<0.0001；6 分钟步行测试，353.85±127.62 比 392.59±123.14，p=0.0002]有显著改善。初步结果显示，CHF 和 COPD 老年患者的认知、心理社会、虚弱和功能特征具有相当大的同质性。然而，特定的康复干预措施在这两种临床人群中似乎都很有前景。本试验已在 ClinicalTrials.gov 注册，注册号为 NCT05230927（clinicaltrials.gov/ct2/show/NCT05230927）。
