Risk of Frailty in Elderly With COPD: A Population-Based Study.
BACKGROUND
Despite frailty being an important geriatric syndrome, its prevalence and associated mortality risk in older patients with chronic obstructive pulmonary disease (COPD) are unknown.


METHODS
We examined the relationship between COPD confirmed by spirometry, COPD severity, and frailty defined by the Fried criteria within 2,142 participants (aged 74.7 ± 5.6 years) of the Rotterdam Study, a prospective population-based cohort study.


RESULTS
The frailty prevalence was significantly higher (p < .001) in participants with COPD (10.2%, 95% CI: 7.6%-13.5%) compared with participants without COPD (3.4%, 95% CI: 2.6%-4.4%). Adjusted for age, sex, smoking, corticosteroids, and other confounders, participants with COPD had a more than twofold increased prevalence of frailty (odds ratio 2.2, 95% CI: 1.34-3.54, p = .002). The prevalence was highest when severe airflow limitation, dyspnea, and frequent exacerbations were present. Participants with mild airflow limitation were more frequently prefrail. COPD elderly who were frail had significant worse survival.


CONCLUSIONS
This population-based cohort study in elderly demonstrates that COPD is associated with frailty even after adjusting for shared risk factors. Our findings suggest that frailty-in addition to COPD severity and comorbidities-identifies those COPD participants at high risk of mortality.
Department of Respiratory Medicine, Ghent University and Ghent University Hospital, De Pintelaan, Belgium. Departments of Epidemiology.
Lies
L
Lahousse
Departments of Epidemiology.
Gijsbertus
G
Ziere
Departments of Epidemiology, Radiology, and.
Vincentius J A
VJ
Verlinden
Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands. Netherlands Consortium on Healthy Aging (NCHA), Leiden, The Netherlands.
M Carola
MC
Zillikens
Departments of Epidemiology, Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands. Netherlands Consortium on Healthy Aging (NCHA), Leiden, The Netherlands.
André G
AG
Uitterlinden
Departments of Epidemiology, Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands. Netherlands Consortium on Healthy Aging (NCHA), Leiden, The Netherlands.
Fernando
F
Rivadeneira
Departments of Epidemiology, Netherlands Consortium on Healthy Aging (NCHA), Leiden, The Netherlands.
Henning
H
Tiemeier
Department of Respiratory Medicine, Ghent University and Ghent University Hospital, De Pintelaan, Belgium.
Guy F
GF
Joos
Departments of Epidemiology, Netherlands Consortium on Healthy Aging (NCHA), Leiden, The Netherlands.
Albert
A
Hofman
Departments of Epidemiology, Radiology, and Netherlands Consortium on Healthy Aging (NCHA), Leiden, The Netherlands. Departments of Neurology and.
M Arfan
MA
Ikram
Departments of Epidemiology, Netherlands Consortium on Healthy Aging (NCHA), Leiden, The Netherlands.
Oscar H
OH
Franco
Department of Respiratory Medicine, Ghent University and Ghent University Hospital, De Pintelaan, Belgium. Departments of Epidemiology, Respiratory Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.
Guy G
GG
Brusselle
Departments of Epidemiology, Netherlands Consortium on Healthy Aging (NCHA), Leiden, The Netherlands. Inspectorate of Healthcare, The Hague, The Netherlands. b.stricker@erasmusmc.nl.
Bruno H
BH
Stricker
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005541:Forced Expiratory Volume; D016330:Frail Elderly; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D008297:Male; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000175:diagnosis / Q000401:mortality*; D012307:Risk Factors; D013147:Spirometry; D014797:Vital Capacity
Chronic obstructive pulmonary disease; Epidemiology; Frailty; Mortality; Multimorbidities; Pulmonary