Asthma is associated with frailty among community-dwelling adults: the GAZEL cohort

Abstract

IntroductionEarly 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.MethodsCurrent 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.ResultsIn 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)).DiscussionParticipants 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.

Epidemiological status and associated factors of frailty and pre-frailty in older adults with asthma in China: A national cross-sectional study

“…Our study found a high age-sex standardized prevalence of frailty in older adults with asthma of 35.8% (95% CI 34.8%−36.7%) and an age-sex standardized prevalence of pre-frailty of 54.5% (95% CI 53.5%−55.5%), with a 3.3-fold increase in the prevalence of frailty in older adults with asthma compared to older adults without asthma. The results of our study are generally consistent with those of a small study who found a 37% prevalence of frailty among 203 older outpatients with asthma aged 60 years or older (17), and we report a higher prevalence of frailty among older adults with asthma than a Brazilian cohort study that reported 13% of older patients with current asthma had frailty in 2015 (18). Chronic inflammation in asthmatics is not only present in the respiratory tract but is systemic, characterized by increased levels of peripheral blood eosinophils, immunoglobulin E and type 2 cytokines.…”

Strength of association between comorbidities and asthma: a meta-analysis

“…Two cohort studies [ 49 , 57 ] and two case–control studies [ 63 , 65 ] achieved a NOS score ≥7 and were considered of high quality, while 12 cohort studies [ 50 – 56 , 58 – 62 ] and two case–control studies [ 64 , 66 ] obtained a NOS score ≤6 and were regarded as of low quality. Quality assessment of cross-sectional studies indicated that five [ 6 , 39 , 43 , 46 , 48 ] were at low risk of bias, eight [ 35 – 38 , 41 , 44 , 45 , 47 ] were at medium risk of bias and two [ 40 , 42 ] were at high risk of bias.…”

Are frailty and patient‐reported outcomes independent in subjects with asthma? A cross‐sectional observational study

“…As far as we are aware, only one epidemiological study of frailty in asthma patients has been published hitherto, 18 and this is the second report on the prevalence of frailty and its close relationship with HRQOL in patients with asthma. The present study showed that the prevalence of frailty was 14.5% in 69participantswith asthma, whose mean age was 69.4 years, including 15.4% of the 52 with AIE.…”

“…The French epidemiologic cohort study recently reported that participants with asthma have increased risk of frailty. 18 The authors hypothesized that frailty status could be associated with the severity of asthma or other clinical features including physiological factors, asthma control, or HRQOL. The purpose of the present study was to examine the prevalence of frailty and to clarify its relationship with features of asthma in a clinical setting.…”