Physical frailty prognostic of disability, mortality in COPD

Chronic obstructive pulmonary disease (COPD) patients frequently develop physical frailty, which provides prognostic information, a study has found.

The study used data from the Singapore Longitudinal Ageing Study involving community-dwelling adults aged ≥55 years. There were 1,162 participants with COPD and 3,465 control participants without COPD included in the analysis.

Researchers estimated prevalent and incident instrumental activities of daily living (IADL)/basic activities of daily living (ADL) disability at 3–5 years follow-up and all-cause mortality up to 11 years. At baseline, prefrailty and frailty had prevalence rates of 48.8 percent and 6.8 percent, respectively, in the COPD group.

Multivariable logistic regression analysis confirmed that the COPD group had much higher odds of physical frailty than the non-COPD control group (odds ratio [OR], 1.61, 95 percent confidence interval [CI], 1.15–2.26).

Furthermore, prefrailty/frailty was strongly associated with twofold greater odds of prevalent and incident IADL/ADL disability and mortality in the COPD group. When combined with either FEV1% <80 percent or dyspnoea, frailty was associated with three- to fourfold odds of prevalent and incident IADL/ADL disability as well as two- to threefold increased mortality hazard.

A summary score incorporating physical frailty, FEV1% <80 percent, and dyspnoea predicted steeper risk gradients of prevalent and incident IADL/ADL disability and mortality across the four risk categories of COPD. The highest risk category predicted between 7- and 8.5-fold increased risks in crude analyses, which remained significantly high despite covariate adjustment.

The findings support the use of physical frailty in addition to lung function and dyspnoea in multidimensional evaluation of COPD.