In elderly patients with chronic obstructive pulmonary disease (COPD), lung function progressively declines, exercise tolerance decreases, and recurrent acute exacerbations are common. Non-invasive ventilation (NIV) alone is difficult to improve skeletal muscle function and long-term quality of life. To investigate the clinical effects of precision pulmonary rehabilitation training combined with non-invasive ventilation (NIV) on the prognosis of elderly patients with COPD, clarify the application value of this combined regimen in elderly COPD, and explore individualized pulmonary rehabilitation models, thereby providing a clinical reference for optimizing comprehensive management of elderly COPD, reducing readmissions, and improving patients′quality of life.

A total of 138 elderly patients with COPD admitted to our hospital from July 1, 2023, to June 30, 2025, were selected and randomly divided into a control group 68 cases and an observation group 70 cases. Pulmonary function, respiratory rate, exercise endurance, laboratory indicators, quality of life-related scales, and mental health scales were recorded for both groups before treatment (H₀) and at 5 days (H₁), 30 days (H₂), and 90 days (H₃) of treatment.

The observation group showed better improvements than the control group in the following parameters: forced expiratory volume in the first second (FEV₁) percentage (11.00% vs. 9.00%, P=0.009), FEV₁/forced vital capacity ratio (FVC) (9.00% vs. 5.00%, P<0.001), respiratory rate (-7.00 breaths/min vs. -4.00 breaths/min, P<0.001), 6-minute walking distance(6MWD) (P<0.001), Borg score(P<0.001), modified British Medical Research Council dyspnea scale score(mMRC) (P<0.001), body mass index-obstruction-dyspnea-exercise index(BODE) (-2.10 points vs. -1.20 points, P<0.001), COPD assessment test score(CAT) (-9.00 points vs. -4.00 points, P<0.001), Epworth Sleepiness Scale score(CAT)(-9.00 points vs. -5.00 points, P<0.001), and sleep apnea clinical score(SACS) (-7.00 points vs. -4.00 points, P<0.001). At H₁-H₃, the observation group exhibited greater reductions in procalcitonin(PCT) and arterial partial pressure of carbon dioxide(PaCO₂), as well as greater increases in arterial partial pressure of oxygen(PaO₂) compared with the control group, with significant group × time interaction effects (F=42.208, 413.330, 81.261, all P<0.001). At H3, the observation group′s Self-Rating Anxiety Scale and Geriatric Depression Scale scores were lower than those of the control group[ (52.17±5.29) vs. (54.29±5.90) points, P=0.028; (7.55±2.79) points vs. (10.64±3.34) points, P<0.001].

Precision pulmonary rehabilitation training combined with NIV can improve pulmonary function, quality of life, and mental health in elderly patients with COPD, and has clinical significance.