Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Echappement aux anti-infectieux et pharmaco-épidémiologie, CESP, 94807, Villejuif, France.
Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie Respiratoire Intégrative, CESP, 94807, Villejuif, France
BMJ Open Respir Res. 2020 Feb;7(1). doi: 10.1136/bmjresp-2019-000526.
Early management of chronic respiratory diseases (CRDs) and frailty have been identified as key targets towards healthy ageing, but the association between CRDs and frailty has been poorly investigated. We studied the association between asthma and frailty in adults of the GAZEL cohort using different definitions of asthma over the 26 years of follow-up.
Current asthma definitions are based on yearly self-reports of symptoms or medication (in 2015, constant reports or at least one report between 1990 and 2015), or on a detailed respiratory symptoms questionnaire in 2002. Frailty definition is based on weakness, fatigue, unintentional weight loss, low physical activity and mobility in 2015. Frail participants had three criteria or more, pre-frail 1 or 2, and robust 0. Multinomial regression models adjusted for age, sex, body mass index, smoking, education, marital status and comorbidities were performed.
In 2015, 12 345 adults (73% men, 61 to 77 years old) were included: 3% of them reported current asthma, 1.6% had constant reports during the follow-up and 9% reported current asthma at least once. In 2015, 6% were frail, 34% pre-frail and 13% of current asthmatics and 6% of non-asthmatics were frail (adjusted OR (aOR) 2.19 (1.44 to 3.34)). Significant associations were also found with the 2002 definition (aOR 2.24 (1.73 to 2.90)), constant reports (aOR 3.67 (1.70 to 7.93)) or at least once (aOR 1.50 (1.15 to 1.98)). Current asthma was also associated with pre-frailty with the 2002 definition (aOR 1.46 (1.26 to 1.68)).
Participants with asthma had increased risk of frailty. A better understanding of their relationship could help to define and evaluate strategies for a better ageing of asthmatics.
慢性呼吸道疾病（CRD）和虚弱的早期管理已被确定为健康老龄化的关键目标，但 CRD 与虚弱之间的关联尚未得到充分研究。我们使用 GAZEL 队列中 26 年的随访数据，通过不同的哮喘定义研究了成年人中哮喘与虚弱之间的关系。
目前的哮喘定义基于每年的症状或药物自我报告（2015 年，持续报告或至少在 1990 年至 2015 年期间有一次报告），或基于 2002 年详细的呼吸道症状问卷。虚弱的定义基于 2015 年的乏力、疲劳、非故意体重减轻、体力活动和移动能力下降。虚弱的参与者有三个或更多标准，虚弱前期有 1 或 2 个标准，而健康的参与者没有标准。多变量回归模型调整了年龄、性别、体重指数、吸烟、教育、婚姻状况和合并症。
2015 年，纳入了 12345 名成年人（73%为男性，年龄在 61 至 77 岁之间）：其中 3%报告有当前哮喘，1.6%在随访期间有持续报告，9%至少报告过一次当前哮喘。2015 年，6%的人虚弱，34%的人虚弱前期，13%的当前哮喘患者和 6%的非哮喘患者虚弱（调整后的比值比（aOR）2.19（1.44 至 3.34））。与 2002 年的定义（aOR 2.24（1.73 至 2.90））、持续报告（aOR 3.67（1.70 至 7.93））或至少一次报告（aOR 1.50（1.15 至 1.98））也存在显著关联。2002 年的定义还表明，当前哮喘与虚弱前期也存在关联（aOR 1.46（1.26 至 1.68））。
有哮喘的参与者患虚弱的风险增加。更好地了解它们之间的关系可以帮助定义和评估改善哮喘患者老龄化的策略。
