Nurse-led pulmonary rehabilitation: a cornerstone for healthy aging in chronic respiratory diseases

The global aging population has driven a substantial increase in chronic respiratory disease (CRD) prevalence, profoundly threatening functional independence and quality of life among older adults. Although pulmonary rehabilitation constitutes a grade A evidence-based intervention, traditional center-based models encounter persistent implementation challenges, including inadequate referral rates, limited accessibility, and poor patient adherence. This perspective article argues that nurse-led pulmonary rehabilitation (NLPR), distinguished by its holistic, continuous, and patient-centered approach, represents not merely an alternative service delivery model but a fundamental strategy for operationalizing healthy aging principles within CRD management. By integrating multimorbidity management, catalyzing self-efficacy, and bridging hospital-community care transitions, NLPR reshapes health trajectories for older adults living with respiratory conditions. This perspective article elaborates four pillars through which NLPR contributes to healthy aging: physiological restructuring, psychological safeguarding, social participation fostering, and advance care planning integration. It further examines implementation barriers, including policy gaps and workforce development needs, while identifying research priorities spanning health economics, protocol personalization, and outcome measurement expansion. Ultimately, NLPR offers a transformative pathway for reconceptualizing CRD from inevitably disabling conditions toward manageable states compatible with meaningful living in later years.