Older COPD Patients Can Reverse, Reduce Frailty with Pulmonary Rehabilitation

A new study published in the journal Thorax suggests pulmonary rehabilitation can reduce the frailty of older people with chronic obstructive pulmonary disease (COPD).

Dr. Matthew Maddocks, of King’s College London and the first author of the study, said in a press release: “Frailty affects one in ten over-65s, and one in four over-80s. We now have a good understanding of how to measure frailty through various tests, and our latest study shows that a combination of exercise training and education can help to reverse this in many people.”

Researchers recruited 816 outpatients with COPD between 2011 and 2015 for the study. The mean age of participants was 70 years old.  To assess frailty, measurements in weight loss, exhaustion, low physical activity, slowness and weakness were measured before and after pulmonary rehabilitation.

The 8-week program consisted of exercise and multidisciplinary education, comprising topics such as physical activity and exercise, medication use, diet, smoking cessation, and coping strategies.

The results showed:

• More than 25% of the participants with COPD referred for rehabilitation were frail.

• The frail participants had double the odds of not finishing the rehabilitation program becuase of  worsened condition or admission to hospital.

• The frail participants who completed the rehabilitation program scored consistently better in measures of breathlessness, exercise performance, physical activity and health status compared to those not classified as frail.

• 61% of the frail participants were no longer classified as frail at the end of the program.

The authors concluded that people with COPD respond favorably to pulmonary rehabilitation, and such programs could reverse their frailty.

Results were published in the article “Physical frailty and pulmonary rehabilitation in COPD: a prospective cohort study.”

According to the British Geriatric Society, frailty affects around 10% of people over the age of 65, but the number rises considerably for people over age 85. Chronic disease such as COPD can speed health decline and advance the state of frailty which leads to greater risk for falls, disability, hospitalization and death.