Geriatric respiratory medicine 2026: from artificial intelligence to personalised management of the multimorbid patient.
21 affiliations
- 1Ospedale Sant'Anna di Como, ASST Lariana, Como, Italy.
- 2Respiratory Diseases Unit, AOUS Le Scotte Hospital, Siena, Italy.
- 3Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Rozzano, Italy.
- 4Policlinico di Bari Ospedale Giovanni XXIII, Bari, Italy.
- 5Me.Pre.CC., Università degli Studi di Palermo, Palermo, Italy.
- 6University of Palermo, Palermo, Italy.
- 7Department of Medical and Surgical Sciences (DSMC), University of Foggia, Foggia, Italy.
- 8Medicina Traslazionale, Universita degli Studi del Piemonte Orientale Amedeo Avogadro, Novara, Italy.
- 9Department of Clinical Medicine, University of Insubria, Varese, Italy.
- 10Ospedale di Circolo, Varese, Italy.
- 11Magna Graecia University of Catanzaro Health Sciences Department, Catanzaro, Italy.
- 12University of Amsterdam, Amsterdam, The Netherlands.
- 13University of Eastern Piedmont, Vercelli, Italy.
- 14University of Rome Tor Vergata, Rome, Italy.
- 15Campus Bio-Medico University Hospital, Rome, Italy.
- 16Ordine dei Medici Palermo, Palermo, Italy.
- 17Dipartimento Biomedico di Medicina Interna e Specialistica (Di. Bi.M.I.S), Palermo, Italy.
- 18Department of Medicine and Surgery, University of Salerno, Baronissi, Italy.
- 19Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, Palermo, Italy.
- 20Centro di Riabilitazione Motoria di Volterra, Volterra, Italy.
- 21PROMISE, University of Palermo, Palermo, Italy [email protected].
Abstract
The profound demographic shift toward an ageing population has decisively moved the burden of chronic and acute lung diseases towards older adults, necessitating a transition from organ-centred models to integrated, multidimensional care. This review outlines a pragmatic framework for managing the complex interplay of immunosenescence, frailty and multimorbidity. In acute care, "pneumonia-associated sarcopenia" is identified as a critical driver of recurrent infections and functional decline, requiring a shift towards aspiration prevention and the aid of diagnostic tools such as lung ultrasound. The selection of noninvasive respiratory support, including high-flow nasal cannulas and noninvasive ventilation, must balance physiological efficacy with the risks of delirium and patient self-inflicted lung injury. Preventive strategies have evolved with the introduction of 20-valent pneumococcal and respiratory syncytial virus vaccines, alongside proactive screening for ɑ1-antitrypsin deficiency to enable precision interventions. Chronic disease management emphasises a "device-centric" inhalation therapy approach, tailoring delivery systems to impaired peak inspiratory flows and cognitive status rather than to pharmacology alone. The advent of biological therapies, particularly the use of dupilumab and mepolizumab in eosinophilic COPD, offers a transformative "steroid-sparing" effect, aiming for clinical stability and preserved independence. Finally, the integration of artificial intelligence as "augmented intelligence" and the "4Ms" multidisciplinary model (mentation, medication, mobility, morbidities) provide the necessary tools to navigate clinical complexity. This holistic strategy ensures that technological innovation remains anchored in patient-centred goals.
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BibTeX
@article{sorino2026geriatric,
title = {{Geriatric respiratory medicine 2026: from artificial intelligence to personalised management of the multimorbid patient.}},
author = {Claudio Sorino and Paolo Cameli and Giorgio Walter Canonica and Giovanna Elisiana Carpagnano and Andrea Cortegiani and Claudio Costantino and Danilo Di Bona and Mario Malerba and Andrea Maresca and Corrado Pelaia and Stefania Principe and Beatrice Ragnoli and Paola Rogliani and Simone Scarlata and Alessandra Tomasello and Luigi Tramonte and Antonino Tuttolomondo and Alessandro Vatrella and Patrizio Vitulo and Anna Zito and Nicola Scichilone},
journal = {European respiratory review : an official journal of the European Respiratory Society},
year = {2026},
month = oct,
doi = {10.1183/16000617.0115-2026},
url = {https://europepmc.org/article/MED/42906940},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Geriatric respiratory medicine 2026: from artificial intelligence to personalised management of the multimorbid patient.
AU - Claudio Sorino
AU - Paolo Cameli
AU - Giorgio Walter Canonica
AU - Giovanna Elisiana Carpagnano
AU - Andrea Cortegiani
AU - Claudio Costantino
AU - Danilo Di Bona
AU - Mario Malerba
AU - Andrea Maresca
AU - Corrado Pelaia
AU - Stefania Principe
AU - Beatrice Ragnoli
AU - Paola Rogliani
AU - Simone Scarlata
AU - Alessandra Tomasello
AU - Luigi Tramonte
AU - Antonino Tuttolomondo
AU - Alessandro Vatrella
AU - Patrizio Vitulo
AU - Anna Zito
AU - Nicola Scichilone
PY - 2026
DA - 2026/10/21
JO - European respiratory review : an official journal of the European Respiratory Society
DO - 10.1183/16000617.0115-2026
UR - https://europepmc.org/article/MED/42906940
AB - The profound demographic shift toward an ageing population has decisively moved the burden of chronic and acute lung diseases towards older adults, necessitating a transition from organ-centred models to integrated, multidimensional care. This review outlines a pragmatic framework for managing the complex interplay of immunosenescence, frailty and multimorbidity. In acute care, "pneumonia-associated sarcopenia" is identified as a critical driver of recurrent infections and functional decline, requiring a shift towards aspiration prevention and the aid of diagnostic tools such as lung ultrasound. The selection of noninvasive respiratory support, including high-flow nasal cannulas and noninvasive ventilation, must balance physiological efficacy with the risks of delirium and patient self-inflicted lung injury. Preventive strategies have evolved with the introduction of 20-valent pneumococcal and respiratory syncytial virus vaccines, alongside proactive screening for ɑ1-antitrypsin deficiency to enable precision interventions. Chronic disease management emphasises a "device-centric" inhalation therapy approach, tailoring delivery systems to impaired peak inspiratory flows and cognitive status rather than to pharmacology alone. The advent of biological therapies, particularly the use of dupilumab and mepolizumab in eosinophilic COPD, offers a transformative "steroid-sparing" effect, aiming for clinical stability and preserved independence. Finally, the integration of artificial intelligence as "augmented intelligence" and the "4Ms" multidisciplinary model (mentation, medication, mobility, morbidities) provide the necessary tools to navigate clinical complexity. This holistic strategy ensures that technological innovation remains anchored in patient-centred goals.
SN - 0905-9180
SN - 1600-0617
ER -