Assessment of frailty and its predictors in chronic obstructive pulmonary disease

Abstract

Background: Frailty represents a state of risk in which a relatively small stressor results in a disproportionate decline in health status. This study aims to determine the prevalence of frailty among patients with COPD in the Indian population and its associated risk factors. Methods: A descriptive cross‑sectional study was conducted in 150 COPD patients. Frailty was assessed using the frailty phenotype method. Results: The mean age (SD) of the study population was 60.59 (5.9) years with 88.67% males and 53.33% ex‑smokers. The prevalence of frailty was 51.33% (n = 77). Most of the frail patients belonged to GOLD group D (66.23%) (P < 0.0001). Post‑bronchodilator FEV1(%) was lowest in the frail group (40 [36–47]%) (P < 0.0001). Risk of frailty significantly correlated with smoking pack years (1.036; 1.001–1.074), history of 1 exacerbation in last year (6.810; 2.036–22.779), post‑bronchodilator FVC(%) (0.955; 0.926–0.985), post‑bronchodilator FEV1(%) (0.940; 0.913–0.968), distance covered in 6‑minute walk test [0.975; 0.965–0.986] and dyspnoea severity [1.044; 1.024–1.063]. In multivariate regression, 6‑minute walk distance and GOLD group B were the independent predictors of frailty in COPD. Conclusion: The prevalence of frailty in Indian patients with COPD was 51.33%. Six‑minute walk distance is an important predictor of frailty. Early identification of frailty will lead to prompt intervention and rehabilitation.