An Age-Friendly Approach to Caring for Chronic Lung Disease in the Ambulatory Setting

Many common chronic lung diseases, such as chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD), have much greater prevalence among older adults and as a result, pose a substantial burden of morbidity, disability, and mortality. The care of older adults with chronic lung disease necessitates an age-friendly approach due to marked differences in physiology, clinical presentation, disease trajectories, and healthcare priorities as compared to younger adults. Pulmonary care models have historically prioritised disease-focused approaches over person-centered care. Disease-focused care fails to adequately address geriatric syndromes that complicate the management of chronic disease, such as multicomplexity, functional impairment, cognitive dysfunction, and psychosocial complexity. In this narrative review, we propose a deliberate, geriatrics-informed approach to ambulatory pulmonary care using the Age-Friendly 5Ms framework-What Matters, Medications, Mentation, Mobility, and Multicomplexity. This framework is an easy-to-use reference for chronic disease management and offers a practical roadmap to support clinical decision-making, inform health system improvement, and guide future research focused on outcomes that matter most to older adults living with chronic lung disease. We review how the 5 M framework helps to align care with patients' goals and values, minimize medication-related harms, address cognitive, psychological, and caregiving needs, preserve mobility and functional independence, and manage the intersecting medical and social challenges common in later life.