Ageing with Interstitial lung disease: preserving health and well being

Abstract

Purpose of reviewAgeing, the accrual of molecular and cellular damage over a lifetime confers progressive physiologic dysfunction of bodily systems, leaving the body in a heightened state of vulnerability to biophysical and psychosocial stressors. The inflection point is frailty which easily leads to disability and death. Interstitial lung disease (ILD) creates biophysical and psychosocial stresses difficult for even optimally fit patients to cope with. With evolving ILD treatment pathways, people with ILD are living longer. Recent findingsILD and ageing are bi-directionally influential: ILD, its treatments, complications, and collateral systemic extra-pulmonary damage (hypoxic and oxidative stress) wear on the ageing person and ageing impacts a person's tolerance of ILD. ILD extent may proportionally accelerate age-related vulnerabilities. ILD related to inflammatory systemic diseases, e.g. connective tissue diseases or sarcoidosis, exert an even more complex biophysical impact on the body.

Sarcoidosis and frailty: recognizing factors that foster holistic resilience

“…We describe a framework containing four overarching domains that encapsulate holistic well-being [3,6 ▪▪ ,9 ▪▪ ,11,12,32,33] and focuses on the assessment and fortification of resilience in sarcoidosis and other multiorgan conditions. Figure 1 depicts an open-ended nonprescriptive confluence intended to invigorate opportunities for risk recognition, health education, personalization, and possibility centered on patients’ priorities and preferences.…”

“…cognitive-psychological well-being (Table 2) [3,9 ▪▪ ,35 ▪▪ ,36 ▪▪ ,37 ▪▪ ,38,39] which involves awareness of domain-relevant history and changes, and includes communication access and literacy, sensory optimization, social connectedness, memory, capacity to learn, self-governance, sense of purpose, interest and pleasure…”

“…Concepts of frailty risk are presented from the lens of preserving holistic well-being when living with sarcoidosis, with the consideration of ageless holistic resilience as a unifying concept in frailty prevention. The framework is informed by previous work [3,6 ▪▪ ,9 ▪▪ ,10 ▪ ] on patient-experiences in sarcoidosis, in interstitial lung disease (ILD) and frailty in ILD. This study sets out to support clinicians in considering early, ageless and positive health-centred strategies for frailty prevention in sarcoidosis [11]…”

“…Healthcare access and adequacy correlate with disparities in race and ethnicity and with lower socioeconomic status, which impact sarcoidosis-related death and disability [4 ▪▪ ,6 ▪▪ ,8 ▪▪ ]. These factors are crucial influences on outcomes for reversible/modifiable risk for frailty [8 ▪▪ ,9 ▪▪ ].…”

“…)[3,9 Factors of Societal Vulnerability that Influence Holistic Resilience in Sarcoidosis Factors of Societal Vulnerability include health risk factors related to the following living areas:…”