Coronary artery diseaseMeta-Analysis of the Effect of Cardiac Rehabilitation Interventions on Depression Outcomes in Adults 64 Years of Age and Older
Section snippets
Methods
We conducted a systematic electronic search of the PsycINFO, PubMed, ClinialTrial.gov, Central Register of Controlled Trials, and CINAHL databases. Relevant treatment trials were searched using the following keywords: depress*, elder*, geri*, heart disease or heart failure, old*, randomized, and trial. We reviewed studies of community-based CR interventions offered in the home or outpatient clinic setting for older adults diagnosed with heart disease. For this review, heart disease was defined
Results
Eighteen studies13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30 of an elderly CR patient population were included in the analysis (Table 1). The review was comprised of 9 studies conducted in the United States, 4 studies in the United Kingdom, 2 studies in Canada, 1 study in Italy, 1 study in Japan, and 1 study in Taiwan. In Table 1, each study is assigned a reference number for ease of reading with uniformly extracted data and cited in the reference section. Overall,
Discussion
Overall, the present meta-analysis suggests that community-based CR programs demonstrate a positive impact on depression outcomes ranging from small to large ESs. It also suggests that most in-home trials significantly mitigated depression symptoms. The impact of these interventions may be explained in part to the ability of trained interventionists to screen and detect early medical and mental health symptoms, provide education and behavioral health services, and request prompt consultation
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Cardiac rehabilitation in older adults: Apropos yet significantly underutilized
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2020, Preventive MedicineCitation Excerpt :One option is to improve attendance at CR, a comprehensive program focused on management of modifiable risk factors in cardiac patients. Importantly, CR is structured to address many of these risk factors including smoking cessation, physical activity and medication compliance (Ades, 2001) and participation at CR is associated with reductions in morbidity and mortality (Heran et al., 2011) and patients who participate in CR report improvements in exercise capacity, quality of life, and mental health (Puetz et al., 2006; Gellis and Kang-Yi, 2012). Unfortunately, cardiac patients who smoke (i.e., those who could benefit the most from secondary prevention) are also less likely to attend CR, as seen in the current data, and consistent with previous findings (Gaalema et al., 2015, 2017).
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2019, Clinics in Geriatric MedicineCitation Excerpt :A meta-analysis of 18 randomized controlled trials assessed the effect of CR on depression in older adults, aged more than 64 years. They found that exercise therapy combined with psychological interventions was more effective in decreasing depression than usual care.65 Therefore, the addition of cognitive behavioral therapy to the current multidisciplinary CR program may improve both depression and mortality in individuals with depression, and a reduction in depression can improve physical function and quality of life in these patients.
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