Older people fail to recognise the signs of cardiac arrest

An Australian study has found a disturbing number of older people fail to recognise the signs of cardiac arrest and do not know what to do in the event of such an emergency.

Despite older people being more likely to experience or witness a heart attack, the study found 72% of people over 60 had never been trained in cardiopulmonary resuscitation (CPR) and 12% did not even know the 000 emergency number.

JCU Occupational Therapy Professor Michele Clark said community-based training in CPR needed to target people over 40 to improve survival rates associated with cardiac arrest.

She said people over 60 were significantly less knowledgeable about the symptoms of a heart attack than those in their thirties, and one and a half times more likely to have limited knowledge of risk factors.

This group has the lowest knowledge of risk factors, symptoms, the emergency telephone number and CPR, yet is most at risk of experiencing or witnessing a cardiac arrest among peers, Professor Clark said.

Education and training for the older population is a crucial step towards increasing survival from cardiac arrest.

Professor Clark has co-authored a paper on levels of cardiac knowledge and CPR training in older Queenslanders for the latest issue of the Australasian Journal on Ageing.

She says coronary heart disease is Australia's leading cause of death.

The typical heart attack victim is male and most cardiac events occur in or near the home.

In fact, 77% of out-of-hospital cardiac arrests to which the Queensland Ambulance Service (QAS) responds occur at a domestic residence.

Therefore, to minimize cardiac-related deaths, it is imperative that those who live with people in this high-risk population are able to identify a heart attack and act immediately if one occurs.

She said much could be done to prevent heart disease through rapid action and changing health behaviour.

Early CPR can greatly improve survival rates by maintaining the patient's viability for several minutes until life-saving medical interventions can be provided.

But it was also important to know the warning signs. While most of the 4490 people interviewed for the study knew chest pain was a symptom of cardiac arrest, only 38% identified shortness of breath as a signal that something was wrong. Even fewer recognized the importance of spreading pain to the neck, arms and shoulders, and less than 10% realized dizziness, sweating and nausea were also signs.

But it wasn't just people over 60 who struggled to name the symptoms of a heart attack. Participants 18 to 29 years were also significantly less knowledgeable than other age groups about symptoms. But they scored the highest when asked to state the emergency phone number, and were more likely to have completed CPR training.

Smoking was the most commonly identified risk factor in the survey, with 54% of participants naming it as something likely to increase the personal risk of heart disease. Around a third knew that inactivity, being overweight and poor diet were cause for concern, but only a few realized high blood pressure and old age itself were also factors.

Out of a possible 12 risk factors, most people knew only three, with participants over 60 the least able to identify the precursors of coronary heart disease.

Overall, Professor Clark said only 55% of participants had learned CPR, with those over 60 significantly less likely than younger participants to have been recently trained.

In fact, about 72% of people over 60 had never been trained in CPR, compared with 24% of people in the 18-29 age bracket.

Older participants exhibited lower levels of knowledge and training in all areas investigated in the current study, she said.

These age differences remained strong even after controlling for a range of demographic and personal factors.

She said one reason for the differences could be that older people were unlikely to have had the same exposure to emergency medical education as younger people.

Health promotion initiatives such as first aid, safety awareness and healthy eating have only recently been incorporated into the school curriculum. These days, CPR training is offered in work, school and university environments.

Older, retired adults may not have had access to such institutionalized training. Also, community CPR training courses specifically aimed at older people are scarce.

Professor Clark undertook the study in association with researchers from the QAS and the Australian Centre for Prehospital Research at the University of Queensland.

http://www.jcu.edu.au