Table 1.

Opportunities for Cardiac Rehabilitation to Better Manage Geriatric Syndromes

Challenges of Geriatric Care	Opportunities to Intervene and Improve Care	Role of Cardiac Rehabilitation
Harmful processes of care	Reduce deconditioning and disorienting transitions Reduce vulnerabilities to delirium, disability, and institutionalization	Restore mobility and self-efficacy as quickly and safely as possible Aid in transition of patients from hospital-to-home and skilled nursing facility-to-home
Multimorbidity	Clarify symptoms and priorities amidst multiple cardiac and noncardiac diseases that commonly occur in combination	Help coordinate care amidst inherent complexity
Polypharmacy	Reduce medications that tend to rise in number in association with cardiac disease as well as comorbidity	Coordinate with primary physician to discontinue unnecessary medications. Monitor for side effects (eg, hemodynamic, fatigue, appetite) and possible interactions
Sarcopenia and frailty	Atrophy and weakening of skeletal muscle is common because of age and disease	Supervised resistance training to increase strength
	Frailty phenotype characterized by weakening, slowing, exhaustion, and exercise decline	Tailored balance and flexibility training to reduce falls
Reduced health literacy	Increased challenge of education, decision-making, and behavior changes amidst cognitive declines and/or social pressures	Provide disease and risk factor education to optimize self-management. Can help overcome limitations of socioeconomics and cognition with tailored care
Poor adherence	Exacerbated by multimorbidity, polypharmacy, reduced health literacy, and reduced cognition	Reinforce medication adherence through education, family organization, and strategies to overcome impediments