The significance and application of lung-function development over time in clinical settings
The development of lung function starts early in utero and continues through childhood into adolescence, reaching its peak in early adulthood before gradually declining due to physiological aging. Lung function trajectory can be influenced positively or negatively by various factors such as diseases and environmental exposures at any age. Research indicates that different lung function trajectories exist in the population, with below-average trajectories linked to poor health outcomes including respiratory, cardiovascular, metabolic issues, and premature death. Conversely, above-average trajectories are associated with healthy aging.
Studies have identified various lung-function trajectories using methods like statistical modeling and longitudinal profiling, with most studies focusing on FEV1 values. In clinical cohorts of adults with COPD, there is high variability in FEV1 decline, with different trajectories associated with varying health outcomes. Plasticity in lung-function trajectories allows for changes over time, such as catch-up trajectories seen in some individuals from childhood to adulthood. Early interventions in childhood and adolescence can promote lung health and potentially lead to catch-up trajectories.
The interaction between early and late-life risk factors plays a crucial role in determining lung-function trajectories, with factors like childhood disadvantage and exposure to tobacco smoke influencing trajectory outcomes. The concept of multimorbidity in relation to lung-function trajectories suggests that individuals with below-average lung function are at higher risk of developing multiple health conditions. Syndemics theory highlights the interconnectedness of diseases in specific contexts, emphasizing the need to understand and address the shared drivers of disease co-occurrence.
Spirometry is a key test for diagnosing respiratory diseases and assessing lung function as a global health marker. However, it is underutilized in clinical practice, especially for monitoring healthy individuals at risk of unhealthy aging. The proposal to implement lung-function charts akin to pediatric growth charts globally could help monitor lung health across the lifespan. The Lung Function Tracker tool is introduced as a free online resource to facilitate tracking lung-function trajectories in clinical practice.
The potential for trajectory-based interventions to improve lung health is promising but requires rigorous development and evaluation. Research gaps include specificity and sensitivity of lung health check-up programs, cost-effectiveness, and adaptation for low- and middle-income countries. Trajectory-based interventions could involve education, lifestyle modifications, and early targeted interventions for individuals at risk of poor lung health outcomes.
The implementation of lung-function trajectory concepts in routine healthcare requires consideration of patient resources, professional skills, organizational changes, and stakeholder engagement. Strategies to promote optimal lung health at the population level should align with national strategies and promote societal awareness of lung health. Advocacy, patient education, and stakeholder engagement are essential for successful implementation of lung-health screening programs.
In conclusion, understanding lung-function trajectories and implementing tools like the Lung Function Tracker can help detect poor lung health early, monitor disease progression, and promote lung health across the lifespan. By addressing the prerequisites and investments needed for potential lung-health programs, there is an opportunity to empower individuals with knowledge about their lung health and improve respiratory outcomes globally.
Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00016-3/fulltext
Studies have identified various lung-function trajectories using methods like statistical modeling and longitudinal profiling, with most studies focusing on FEV1 values. In clinical cohorts of adults with COPD, there is high variability in FEV1 decline, with different trajectories associated with varying health outcomes. Plasticity in lung-function trajectories allows for changes over time, such as catch-up trajectories seen in some individuals from childhood to adulthood. Early interventions in childhood and adolescence can promote lung health and potentially lead to catch-up trajectories.
The interaction between early and late-life risk factors plays a crucial role in determining lung-function trajectories, with factors like childhood disadvantage and exposure to tobacco smoke influencing trajectory outcomes. The concept of multimorbidity in relation to lung-function trajectories suggests that individuals with below-average lung function are at higher risk of developing multiple health conditions. Syndemics theory highlights the interconnectedness of diseases in specific contexts, emphasizing the need to understand and address the shared drivers of disease co-occurrence.
Spirometry is a key test for diagnosing respiratory diseases and assessing lung function as a global health marker. However, it is underutilized in clinical practice, especially for monitoring healthy individuals at risk of unhealthy aging. The proposal to implement lung-function charts akin to pediatric growth charts globally could help monitor lung health across the lifespan. The Lung Function Tracker tool is introduced as a free online resource to facilitate tracking lung-function trajectories in clinical practice.
The potential for trajectory-based interventions to improve lung health is promising but requires rigorous development and evaluation. Research gaps include specificity and sensitivity of lung health check-up programs, cost-effectiveness, and adaptation for low- and middle-income countries. Trajectory-based interventions could involve education, lifestyle modifications, and early targeted interventions for individuals at risk of poor lung health outcomes.
The implementation of lung-function trajectory concepts in routine healthcare requires consideration of patient resources, professional skills, organizational changes, and stakeholder engagement. Strategies to promote optimal lung health at the population level should align with national strategies and promote societal awareness of lung health. Advocacy, patient education, and stakeholder engagement are essential for successful implementation of lung-health screening programs.
In conclusion, understanding lung-function trajectories and implementing tools like the Lung Function Tracker can help detect poor lung health early, monitor disease progression, and promote lung health across the lifespan. By addressing the prerequisites and investments needed for potential lung-health programs, there is an opportunity to empower individuals with knowledge about their lung health and improve respiratory outcomes globally.
Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00016-3/fulltext
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