Lahousse Lies, Ziere Gijsbertus, Verlinden Vincentius J A, Zillikens M Carola, Uitterlinden André G, Rivadeneira Fernando, Tiemeier Henning, Joos Guy F, Hofman Albert, Ikram M Arfan, Franco Oscar H, Brusselle Guy G, Stricker Bruno H
Department of Respiratory Medicine, Ghent University and Ghent University Hospital, De Pintelaan, Belgium. Departments of Epidemiology.
Departments of Epidemiology.
J Gerontol A Biol Sci Med Sci. 2016 May;71(5):689-95. doi: 10.1093/gerona/glv154. Epub 2015 Sep 9.
Despite frailty being an important geriatric syndrome, its prevalence and associated mortality risk in older patients with chronic obstructive pulmonary disease (COPD) are unknown.
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.
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.
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.
尽管衰弱是一种重要的老年综合征，但其在老年慢性阻塞性肺疾病（COPD）患者中的患病率及相关死亡风险尚不清楚。
在鹿特丹研究（一项基于人群的前瞻性队列研究）的2142名参与者（年龄74.7±5.6岁）中，我们研究了通过肺量计确诊的COPD、COPD严重程度与根据弗里德标准定义的衰弱之间的关系。
与无COPD的参与者（3.4%，95%CI：2.6%-4.4%）相比，COPD参与者的衰弱患病率显著更高（p<0.001）（10.2%，95%CI：7.6%-13.5%）。在调整年龄、性别、吸烟、皮质类固醇及其他混杂因素后，COPD参与者的衰弱患病率增加了两倍多（优势比2.2，95%CI：1.34-3.54，p=0.002）。当存在严重气流受限、呼吸困难和频繁加重时，患病率最高。轻度气流受限的参与者更常处于衰弱前期。衰弱的COPD老年患者的生存率显著更差。
这项针对老年人的基于人群的队列研究表明，即使在调整共同风险因素后，COPD仍与衰弱相关。我们的研究结果表明，除了COPD严重程度和合并症外，衰弱还可识别出COPD参与者中的高死亡风险人群。
