Chronic obstructive lung disease (COPD) is an irreversible condition, which is usually diagnosed in smokers in their 4-5th decade of life. It is the 3rd leading cause of death and a major cause of disability in adults. Besides breathing difficulty, cough and sputum production, COPD is associated with a number of systemic manifestations. 

Frailty is commonly defined as a state of increased vulnerability, multidimensional decline in biological and psychosocial functioning of the individual commonly seen with advanced age. 

This paper assesses the associations between COPD and frailty. The specific question was whether frailty in combination with lung function tests predicted disability and mortality in COPD patients.

This was a prospective cohort study of community-dwelling adults 55 years of age or older in the Singapore Longitudinal Aging Study..  Baseline data of 1162 participants with COPD and 3465 participants without COPD was analyzed for findings of frailty, symptoms and lung function testing. The participants were followed for 6.5-9.5 years on average. 

This study suggested that COPD patients were more likely to become frail compared to similar adults without COPD. The participants with both COPD and findings of frailty had a significant twofold increase in their likelihood of developing disability and mortality. A summary score combining signs of frailty, reduced pulmonary function and symptoms of dyspnea allowed to better predict development of disability and death in patients with COPD.  

The study concluded that assessment for physical frailty in addition to lung function and dyspnea are useful in evaluation of COPD patients and allow to better define prognosis and management for such patients.

These findings imply that if people with COPD work on preserving their social function and physical strength their outcomes will be better. 

Published: December 2021

For the full abstract, follow the link: https://journal.chestnet.org/article/S0012-3692(21)05081-9/fulltext