Response to Pulmonary Rehabilitation in Older People with Physical Frailty, Sarcopenia and Chronic Lung Disease

Abstract

Frailty and sarcopenia are two important clinical syndromes associated with the ageing process, with a high risk of morbidity and mortality. Patients with chronic disease have been shown to have an accelerated decline into a frail state, with patients with both chronic lung disease and frailty having a higher mortality than those with frailty alone. Pulmonary rehabilitation has been found to be an effective intervention in patients with chronic obstructive pulmonary disease (COPD), yet the effect of frailty on this as intervention remains unclear. A narrative literature search of PubMed, Medline complete and the Cochrane library was performed by the reviewers using predefined criteria. Only 3 studies met the selection criteria and were reviewed. These studies highlighted that, although completion rates are lower in patients with both COPD and frailty, pulmonary rehabilitation remains effective as an intervention in this subgroup of patients, with up to 61% of frail patients no longer meeting frailty criteria after completion of a pulmonary rehabilitation programme.

Keywords: chronic obstructive pulmonary disease; frailty; pulmonary rehabilitation; sarcopenia.