Frailty in patients with interstitial lung disease

Abstract

Purpose of reviewThe incidence of age-related diseases such as interstitial lung disease (ILD) is rising, and the importance of multimorbidity and accumulation of health deficits in patients with chronic lung diseases is increasingly recognized. There are multiple relationships between aging and ILD on a demographic and a biological level. Frailty conceptualizes the decline of a patient's physiological reserves and complements the chronological and biological aspects of aging. Recent findingsFrailty affects more than 50% of patients with ILD, with respiratory impairment, accelerated biological aging, comorbidities, medication adverse effects, and social factors collectively playing important roles. Frailty is an independent risk factor for adverse health outcomes such as hospitalizations and early mortality, including before and after lung transplant. Given the multicomponent determinants of frailty, programs such as pulmonary rehabilitation are promising strategies for managing this complex issue. SummaryFrailty is a common risk factor for adverse outcomes in patients with ILD. The multiple pathways leading to frailty are not completely understood, and further studies are needed to determine the optimal tools for assessment and to develop strategies to prevent and counteract frailty in the aging ILD population. Keywords aging, frailty, interstitial lung disease, pulmonary fibrosis]. Given the previous findings from populations of patients with severe lung diseases and the biological and demographic relationship between ILDs and aging [3,9], frailty is also increasingly recognized

Functional clinical impairments and frailty in interstitial lung disease patients

“…The most recent review on pulmonary rehabilitation outcomes [ 52 ] puts emphasis on the potential benefits in improving functional performance and QoL (moderate certainty) and maximum exercise capacity, dyspnoea and long-term survival (low certainty) in ILD patients. In COPD, frail patients respond favourably to pulmonary rehabilitation [ 17 ] and a similar effect could be expected in a population with ILD, although data are still missing for this population [ 53 ]. Because of the high reported prevalence of frailty in patients with ILD [ 50 , 53 ], it is thus crucial to identify and understand the multidimensional concerns of these patients in order to individualise the intervention to suit their needs and priorities [ 54 ].…”

“…In COPD, frail patients respond favourably to pulmonary rehabilitation [ 17 ] and a similar effect could be expected in a population with ILD, although data are still missing for this population [ 53 ]. Because of the high reported prevalence of frailty in patients with ILD [ 50 , 53 ], it is thus crucial to identify and understand the multidimensional concerns of these patients in order to individualise the intervention to suit their needs and priorities [ 54 ].…”

“…In COPD patients, frail patients respond favorably to PR 17 and similar effect could be expected in population with ILD, although data are still missing for this population. 51 Because of the high reported prevalence of frailty in patients with ILD 51 48 , it is thus crucial to identify and understand the multidimensional concerns of these patients in order to individualise the intervention to suit their needs and priorities. 52 Finally, from the novel perspective brought by our findings, the 1STS appear to be a good discrimination test to assess the frailty status in the ILD population.…”

Ageing with Interstitial lung disease: preserving health and well being

“…Preventing deterioration toward frailty is an important goal of ILD care [10 ▪▪ –12 ▪▪ ,14–17 ▪ ]. Central to this is the recognition and management of non-ILD health events and conditions commonly occurring in the general population (Table 1).…”

Openreuma Consensus on the role of nursing in the care of patients with rheumatoid arthritis and diffuse interstitial lung disease

“…Cohort studies have shown that about half of all patients with ILD have frailty and its importance lies in its predictive role in disability, hospitalisation, and mortality. (37,38) Two models of frailty have been described; Fried's model based on biomedical factors, (39) and the Rockwood's model based with a more holistic definition including psychosocial and environmental factors. (40) Assessment of frailty is important for the possibility of intervention.…”