The pulmonary system has two central functions that contribute to maintaining energy and metabolism: taking up oxygen, critical for energy generation, and getting rid of the waste products of respiration that can impair metabolism if allowed to accumulate.  A decline in pulmonary function could therefore contribute to exhaustion and slowing mobility, key components of physical frailty (Singer et al., 2016).  Aging results in a steady decline of lung function after the age of 35 (Zeleznik, 2003), through loss of lung elasticity and decreased surface area for alveolar gas exchange, along with weakened muscles of respiration. Peak lung function, exposures to toxins such as cigarette smoke, and aging related changes in the immune system all play a role in the development of pulmonary impairment in later life.

The relationship between frailty and lung function appears to go in both directions. In the Cardiovascular Heath Study, pre-frail and frail participants had 42% increased likelihood of developing respiratory impairment compared to non-frail participants over 12 years of follow up, while those with lung disease but not frailty at baseline had a 58% increase in the likelihood of becoming pre-frail or frail during follow up (Vaz Fragoso et al., 2012).  Continue Reading