Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Department of Medicine, University of British Columbia.
Curr Opin Pulm Med. 2020 Sep;26(5):449-456. doi: 10.1097/MCP.0000000000000692.
The 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.
Frailty 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.
Frailty 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.
与年龄相关的疾病（如间质性肺病[ILD]）的发病率正在上升，慢性肺部疾病患者的多种合并症和健康缺陷的积累的重要性也日益受到认识。衰老和 ILD 在人口统计学和生物学层面上存在多种关系。衰弱概念化了患者生理储备的下降，并补充了年龄的时间和生物学方面。
衰弱影响了超过 50%的 ILD 患者，呼吸功能障碍、加速的生物衰老、合并症、药物不良反应和社会因素共同起着重要作用。衰弱是不良健康结局（如住院和早期死亡）的独立危险因素，包括在肺移植之前和之后。鉴于衰弱的多因素决定因素，肺康复等计划是管理这一复杂问题的有前途的策略。
衰弱是 ILD 患者不良结局的常见危险因素。导致衰弱的多种途径尚不完全清楚，需要进一步研究以确定最佳评估工具，并制定策略来预防和对抗老年 ILD 人群的衰弱。
