Is it possible to reverse frailty in patients with chronic obstructive pulmonary disease?

Abstract

In recent years, frailty has attracted increasing attention from clinicians and health care workers. The influence of frailty on the elderly, especially those with chronic diseases of the respiratory system, is highly significant. Frailty is particularly more common in patients with chronic obstructive pulmonary disease (COPD). Frailty and COPD share many risk factors and pathophysiological mechanisms. As a comprehensive interventional method for chronic respiratory diseases, pulmonary rehabilitation is an important basic measure for the management of patients with COPD. Frailty in these patients can be reversed using pulmonary rehabilitation by targeting five components of the frailty phenotype at the entry point. The present review discusses the benefits of pulmonary rehabilitation in patients with COPD complicated by frailty and provides a theoretical basis for pulmonary rehabilitation treatment in this population. In addition, the timing of pulmonary rehabilitation is also addressed, with the prefrail stage being the “golden” period. The implementation of pulmonary rehabilitation must vary among individuals, and individualized treatment strategies will help maximize benefits.

Association of geriatric syndromes in older adults with chronic obstructive pulmonary disease

“…Frailty can increase the risk of mortality and morbidity in patients with COPD, whereas COPD can accelerate the progression of pre‐frailty to frailty. Timely diagnosis and intervention of pre‐frail patients with COPD, can prevent progression of prefrailty, improve frailty, and improve disease outcome 9 …”

“…GS increases morbidity, mortality, medication nonadherence, and admission to acute care units 7,8 . Frailty has been the most studied geriatric condition in older patients with COPD, with an increased risk of adverse outcomes: falls, hospitalization, poor quality of life, or death 9 . The other components are understudied, with very few studies focused on the comprehensive assessment of GS in these patients.…”

Frailty and rehabilitation outcome in older patients with cardiorespiratory disease: Preliminary multidimensional data

“…This study provides a specific focus on older and frail patients with CHF or COPD, contributing to bridging a literature gap. Although there is a growing interest concerning these clinical populations, research data are still lacking, controversial, and need further investigations [26,[41][42][43].…”

“…Finally, concerning the comparison between the cognitive, psychological, quality of life, and functional data at admission and discharge, a significant improvement can be observed in all the investigated areas in CHF and COPD patients. The data concerning the benefits of cardiac and pulmonary rehabilitation has been extensively reported in literature in both CHF and COPD patients [41,[57][58][59][60][61][62][63][64][65]. As to CHF, literature shows that cardiac rehabilitation induced significant improvements in physical and psychological parameters in a sample of patients ranging from less than 65 years to 80 years or over [59].…”

Ninjin’yoeito ameliorated PPE-induced pulmonary emphysema and anxiety/depressive-like behavior in aged C57BL/6J mice

“…COPD participants with frailty have higher mortality when compared with non-frail participants ( Roberts et al, 2022 ). Anxiety and depression are well-recognized major comorbidities in COPD and reducing the negative effects of these comorbidities is important in the treatment of frail COPD ( Cafarella et al, 2012 ; Wang et al, 2020 ). Worsening COPD pathophysiology is caused by a breakdown in the normal defense mechanisms of the body, and oxidative stress caused by cigarette smoke and air pollution is strongly implicated in this cause ( Zinellu et al, 2016 ; Barnes, 2020 ).…”