A New Dyspnea Evaluation System Focusing on Patients’ Perceptions of Dyspnea and Their Living Disabilities: The Linkage between COPD and Frailty

Oishi, Keiji; Matsunaga, Kazuto; Harada, Mikihiko; Suizu, Junki; Murakawa, Keita; Chikumoto, Ayumi; Ohteru, Yuichi; Matsuda, Kazuki; Uehara, Sho; Hamada, Kazuki; Ohata, Shuichiro; Murata, Yoriyuki; Yamaji, Yoshikazu; Asami‐Noyama, Maki; Edakuni, Nobutaka; Kakugawa, Tomoyuki; Hirano, Tsunahiko

doi:10.3390/jcm9113580

Cited by 11 publications

(16 citation statements)

References 48 publications

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“…A total of seven studies [ 17 , 23 , 24 , 30 , 31 , 33 , 35 ] investigated the relationship between the COPD CAT score and the risk of frailty in patients with COPD; however, most were unsuitable for extracting data and the meta-analysis could only be performed in terms of two of these studies [ 24 , 33 ]. The results suggested that the CAT score was an indicator for frailty in patients with COPD (OR = 1.19; 95% CI = 1.12–1.27) (Supplemental File 4).…”

Section: Resultsmentioning

confidence: 99%

Prevalence and risk factors of frailty in patients with chronic obstructive pulmonary disease: systematic review and meta-analysis

Yan

Wang

et al. 2023

Eur Geriatr Med

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Objective To systematically review the prevalence and risk factors for frailty in patients with chronic obstructive pulmonary disease (COPD). Methods A systematic review and meta-analysis were conducted, and a search of the PubMed, Embase and Web of Science databases was carried out to collect Chinese and English studies on frailty and COPD published up to September 5, 2022. Results A total of 38 articles were included for the quantitative analysis after the collected literature was either included or omitted based on pertinent criteria. The results indicated that the estimated overall pooled prevalence of frailty was 36% (95% confidence interval [CI] = 31–41%), and the estimated pre-frailty was 43% (95% CI = 37–49%). A higher age (odds ratio [OR] = 1.04; 95% CI = 1.01–1.06) and higher COPD assessment test (CAT) score (OR = 1.19; 95% CI = 1.12–1.27) were associated with a significantly increased likelihood of frailty in patients with COPD. However, a higher educational attainment (OR = 0.55; 95% CI = 0.43–0.69) and higher income (OR = 0.63; 95% CI = 0.45–0.88) were associated with a significantly reduced risk of frailty in patients with COPD. A total of 17 other risk factors for frailty were identified via qualitative synthesis. Conclusion The incidence of frailty in patients with COPD is high, and there are many influencing factors.

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Section: Resultsmentioning

confidence: 99%

Prevalence and risk factors of frailty in patients with chronic obstructive pulmonary disease: systematic review and meta-analysis

Yan

Wang

et al. 2023

Eur Geriatr Med

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“…Seven studies used both mMRC and CAT. Twelve studies [37][38][39][40][41][42][43][44][45][46][47]50] found a positive association between frailty and dyspnoea, whilst two studies reported no association [48,49].…”

Section: Frailty and Symptoms In Copdmentioning

confidence: 99%

“…The link between frailty and symptoms in COPD was explored in 14 [37][38][39][40][41][42][43][44][45][46][47][48][49][50] original research articles across 3097 participants (50% male, 1563/3097) with available data for comparison (Table 2). Of the 14 studies, published between 2016 and 2021, 6 were cohort studies and 8 were cross-sectional.…”

Section: Frailty and Symptoms In Copdmentioning

confidence: 99%

Impact of Frailty on Symptom Burden in Chronic Obstructive Pulmonary Disease

Verduri,

Clini,

Carter

et al. 2024

JCM

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Chronic obstructive pulmonary disease (COPD), the sixth leading cause of death in the United States in 2022 and the third leading cause of death in England and Wales in 2022, is associated with high symptom burden, particularly dyspnoea. Frailty is a complex clinical syndrome associated with an increased vulnerability to adverse health outcomes. The aim of this review was to explore the current evidence of the influence of frailty on symptoms in patients with a confirmed diagnosis of COPD according to GOLD guidelines. Fourteen studies report a positive association between frailty and symptoms, including dyspnoea, assessed with the COPD Assessment Test (CAT) and the modified Medical Research Council (mMRC) scale. Data were analysed in a pooled a random-effects meta-analysis of mean differences (MDs). There was an association between COPD patients living with frailty and increased CAT score versus COPD patients without frailty [pooled SMD, 1.79 (95% CI 0.72–2.87); I2 = 99%]. A lower association was found between frailty and dyspnoea measured by the mMRC scale versus COPD patients without frailty [pooled SMD, 1.91 (95% CI 1.15–2.66); I2 = 98%]. The prevalence of frailty ranged from 8.8% to 82% and that of pre-frailty from 30.4% to 73.7% in people living with COPD. The available evidence supports the role of frailty in worsening symptom burden in COPD patients living with frailty. The review shows that frailty is common in patients with COPD. Future research is needed to have further details related to the data from CAT to improve our knowledge of the frailty impact in this population.

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“…• Consider comorbid conditions (Table 3). [60][61][62][63][64][65] • Late/end-stage COPD: consider opiates/ morphine, lung volume reduction surgery, and lung transplantation.…”

Section: Therapeutic Advances In Respiratory Diseasementioning

confidence: 99%

Stepwise management of COPD: What is next after bronchodilation?

Miravitlles,

Matsunaga,

Dreher

2023

Ther Adv Respir Dis

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Inhaled bronchodilator therapy with long-acting muscarinic antagonists (LAMAs) and long-acting β2-agonists (LABAs) in combination is currently the mainstay of treatment for chronic obstructive pulmonary disease (COPD). Treatment guidelines recommend the addition of inhaled corticosteroids (ICS) to LABA/LAMA only in patients with a history of frequent/severe exacerbations and high blood eosinophil counts, or in those with concomitant asthma. Despite this, real-world data suggest that clinicians are not adhering to this guidance and that ICS are frequently overused. This is possibly due to the incorrect assumption that when LABA/LAMA therapy is not sufficient, adding an ICS to the treatment regimen is the logical next step. In this narrative review, we describe global and country-specific guideline recommendations from Germany, Spain, and Japan and compare these with real-world data on LABA/LAMA and ICS use in clinical practice. We also provide a clinical guide to the use of add-on therapies with LABA/LAMA for different patient phenotypes, including (1) patients still symptomatic (but not exacerbating) despite LABA/LAMA treatment; (2) patients still exacerbating despite LABA/LAMA treatment who have high blood eosinophil counts; and (3) patients still exacerbating despite LABA/LAMA treatment who do not have high blood eosinophils or concomitant asthma.

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A New Dyspnea Evaluation System Focusing on Patients’ Perceptions of Dyspnea and Their Living Disabilities: The Linkage between COPD and Frailty

Cited by 11 publications

References 48 publications

Prevalence and risk factors of frailty in patients with chronic obstructive pulmonary disease: systematic review and meta-analysis

Prevalence and risk factors of frailty in patients with chronic obstructive pulmonary disease: systematic review and meta-analysis

Impact of Frailty on Symptom Burden in Chronic Obstructive Pulmonary Disease

Stepwise management of COPD: What is next after bronchodilation?

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