Frailty syndrome in ambulatory patients with COPD

Limpawattana, Panita; Putraveephong, Siraphong; Inthasuwan, Pratchaya; Boonsawat, Watchara; Theerakulpisut, Daris; Chindaprasirt, Jarin

doi:10.2147/copd.s134233

Cited by 45 publications

(47 citation statements)

References 26 publications

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“…Interestingly, this study was a sub-study of “Sarcopenia in COPD”, which found that sarcopenia was indeed associated with frailty. Therefore, in theory, frail COPD patients might benefit from the prevention of sarcopenia 86. Although the FRAIL scale is a simple, self-report tool to measure frailty based on the phenotype, there have not been any validated studies involving hospitalized participants.…”

Section: Frail Scalementioning

confidence: 99%

Frailty assessment in older adults with chronic obstructive respiratory diseases

Guan¹,

Huang²

2018

CIA

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The number of patients with chronic obstructive pulmonary disease (COPD) has been rising with continued exposure to environmental risk factors and aging of populations around the world. Frailty is a geriatric syndrome with a decline in physiological reserve and often coexists with chronic diseases such as COPD. Frailty is an independent risk factor for the development and progression of COPD, and COPD can lead to frailty; treating one might improve the other. Thus, there is an increasing interest in the assessment of frailty in patients with COPD. Furthermore, early identification and assessment of frailty in patients with COPD may affect the choice of intervention and improve its effectiveness. Based on the current literature, the intent of this review was to summarize and discuss frailty assessment tools used for COPD patients and the relevant clinical practices for predicting outcomes. We ascertain that using suitable frailty assessment tools could facilitate physicians to screen and stratify physically frail patients with COPD. Screening appropriately targeted population can achieve better intervention outcomes and pulmonary rehabilitation among frail COPD patients.

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Section: Frail Scalementioning

confidence: 99%

Frailty assessment in older adults with chronic obstructive respiratory diseases

Guan¹,

Huang²

2018

CIA

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“…53 Using the FRAIL scale (see Table 5 in CQ2), they identified 7% of the COPD patients as frail, and found that fatigue was the most frequent component of the FRAIL scale among the frail patients. 53 Using the FRAIL scale (see Table 5 in CQ2), they identified 7% of the COPD patients as frail, and found that fatigue was the most frequent component of the FRAIL scale among the frail patients.…”

Section: Explanationmentioning

confidence: 99%

“…Limpawattana et al carried out a cross-sectional analysis of 121 COPD patients who attended a COPD clinic in a Thai university hospital. 53 Using the FRAIL scale (see Table 5 in CQ2), they identified 7% of the COPD patients as frail, and found that fatigue was the most frequent component of the FRAIL scale among the frail patients. 54 They also identified 41% of the patients as pre-frail.…”

Section: Explanationmentioning

confidence: 99%

Chapter 4 Frailty and specific diseases

Sugimoto

Rakugi

Kojima

et al. 2020

Geriatrics Gerontology Int

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CQ18: What is the relationship of frailty with orthostatic hypotension and orthostatic intolerance? Summary • Orthostatic hypotension and orthostatic intolerance are more prevalent among frail individuals than non-frail individuals, and these conditions worsen frailty outcomes (evidence level: E-2). ExplanationOrthostatic hypotension and orthostatic intolerance, both of which are risk factors for falls, are reported to be associated with frailty. O'Connell et al. examined the relationship between orthostatic hypotension, orthostatic intolerance and frailty using data from 5692 individuals aged ≥50 years who participated in the Irish Longitudinal Study on Aging (TILDA). Of these participants, 6.1% had orthostatic hypotension, 6.7% had orthostatic intolerance and 4.3% were identified as frail, and 34.5% participants were identified as pre-frail under the Cardiovascular Health Study (CHS) criteria. Both orthostatic hypotension and orthostatic intolerance were more prevalent in frail participants (8.9% and 14.3%) than they were in robust participants (5.0% and 5.7%). In a multivariate analysis, orthostatic intolerance was found to be independently associated with frailty (odds ratio [OR] 1.80, 95% CI 1.13-2.87), although orthostatic hypotension was not. 1 Similarly, Freud et al. examined associations between orthostatic hypotension and mortality using data of patients who were regularly assessed in the outpatient Comprehensive Geriatric Assessment Unit. These patients were aged ≥65 years (mean age 83.7 years), and 32.1% were diagnosed with orthostatic hypotension. They found that orthostatic hypotension was associated with increased mortality (over the follow-up period, 30.2% and 22.3% of those with and without orthostatic hypotension died, respectively), but a multivariate analysis did not show orthostatic hypotension to be independently associated with increased mortality. 2 These studies suggest that orthostatic hypotension and orthostatic intolerance are more prevalent in frail individuals, and that they worsen frailty outcomes.Romero-Ortuno et al. analyzed a sample of older individuals (average age of 72, 6.1% with orthostatic hypotension, 6.7% with orthostatic intolerance) who did not have dementia or risk factors for autonomic neuropathy. They arranged the participants into non-frail, pre-frail and frail groups, and found that the baseline heart rate decreased across the groups in that order. They also found that the delta heart rate (maximum heart rate within 30 s after standing minus baseline heart rate) increased across the groups in that order. It was reported that 30 s after standing, 98% of the non-frail participants, 95% of the pre-frail participants and 92% of the frail participants recovered to their baseline heart rate. 3 These findings suggest that frailty worsens hypostatic problems that occur when standing.CQ19: What is the relationship of frailty with antihypertensive treatment? Summary • Antihypertensive treatment prevents cardiovascular events whether or not the patient is frail. Intensive anti...

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“…9 Notable prevalence of frailty was reported in patients with chronic obstructive pulmonary disease. 10 It is not surprising that Matsushita et al saw the prognostic impact of concomitant pulmonary disease in olderold patients with HFpEF. Some data indicate ACEIs could slow the decrease in muscle strength, a marker of frailty.…”

Section: Comments Heart Failure With Preserved Ejection Fraction In Omentioning

confidence: 99%