| Title: | Association of Physical Frailty With Incidence and Life Expectancy of COPD A Population-Based Cohort Study |
| Journal: | CHEST Journal |
| Published: | 19 Apr 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/40258513/ |
| DOI: | https://doi.org/10.1016/j.chest.2025.03.032 |
Publication 15805
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Abstract
BACKGROUND: The bidirectional relationship between frailty and COPD is documented. However, longitudinal studies examining the combined effects of genetic predisposition and preserved ratio impaired spirometry (PRISm) on frailty in COPD development are lacking.</p>
RESEARCH QUESTION: What is the association between physical frailty and the incidence and mortality of COPD, and how do genetic predisposition and PRISm modify this association?</p>
STUDY DESIGN AND METHODS: We included 412,351 adults without COPD (mean age ± SD, 56.1 ± 8.1 years; 44.3% male) and 60,584 patients with COPD (mean age ± SD, 59.2 ± 7.4 years; 55.1% male) at baseline in the UK Biobank cohort. Frailty phenotypes were assessed using 5 components, including weight loss, exhaustion, low physical activity, slow gait speed, and low grip strength. Cox proportional hazards regression models were used to evaluate the association of genetic predisposition, PRISm, and frailty with COPD development. Life expectancy reductions due to frailty were estimated using life table methods in patients with COPD.</p>
RESULTS: During a median follow-up of 13.5 years, 10,695 incident COPD cases were recorded. In the multivariable-adjusted model, frailty and prefrailty were significantly associated with an increased risk of COPD (hazard ratio, 2.21; 95% CI, 2.06-2.37 for frailty; hazard ratio, 1.45; 95% CI, 1.39-1.51 for prefrailty). Significant interactions were observed between genetic predisposition and frailty (P for interaction = .0252), and between PRISm and frailty (P for interaction = .0027), in the development of COPD. Among patients with COPD at 45 years of age, frailty was associated with a reduction in life expectancy of 8.49 years for male individuals and 7.67 years for female individuals, whereas prefrailty was associated with reductions of 3.27 and 2.78 years, respectively, compared with their nonfrail counterparts.</p>
INTERPRETATION: The results of this study indicate that frailty and prefrailty increase COPD risk and are linked to reduced life expectancy in patients with COPD, highlighting the need for early detection and management of frailty in COPD risk reduction and treatment strategies.</p>
14 Keywords
- Aged
- Cohort Studies
- Female
- Frailty
- Genetic Predisposition to Disease
- Humans
- Incidence
- Life Expectancy
- Male
- Middle Aged
- Pulmonary Disease, Chronic Obstructive
- Risk Factors
- Spirometry
- United Kingdom
11 Authors
- Chao Liu
- Hui Xiong
- Xia Han
- Yanling Lv
- Decai Wang
- Jiannan Hu
- Ziling Li
- Xinyue Ma
- Yunfei Zhu
- Shuyun Xu
- Liangkai Chen
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