Whilst cardiac and pulmonary disease may first present in a more youthful population, many are living with related functional limitations and disability into older years. With a global ageing population cardiac and pulmonary events are also becoming more common in a ‘geriatric’ population. As patients age, they develop unique medical, physical and functional challenges that makes this population unique and as such, approaches to cardiac and pulmonary rehabilitation (C&PR) must adapt to meet these needs. Exercise in C&PR is focused on aerobic / endurance training. However, functional independence throughout ageing relies on a multi-component approach addressing, strength, balance and stability in addition to endurance. We will discuss how C&PR programs for older individuals should include biomechanical and neuromuscular specificity aspects of training integrating balance and stability exercises. Examples of safe and effective exercises as recommended by the American College of Sports Medicine will be presented as well as recommendations for referral to physical and occupational therapy. Sarcopenia is a syndrome characterized by loss of skeletal muscle mass and function primarily seen in the elderly, or in younger persons with complex medical diseases including heart, lung and oncologic disease. Patients develop progressive, generalized loss of skeletal muscle mass and strength correlating with physical disability, poor quality of life and even death. We will address the etiology of sarcopenia and preventive measures in patients with heart, lung and oncologic disease. Evaluation and treatment including nutritional and physical rehabilitation will be discussed. Patient outcomes will be addressed. Participation in C&PR is historically poor – 25% of those who qualify for CR and 5% for PR. Access to ‘center based’ programs can be challenging for many reasons and ageing significantly negatively impacts participation. Remotely delivered ‘community based’ C&PR is evolving and likely can provide solutions to the accessibility challenge. We will discuss the Resilient trial – a study researching the use of mobile health technology to provide remote home / community based CR in older patients after hospitalization for ischemic heart disease.