Effect of acute respiratory illness on short‐term frailty status of older adults in Nakhon Phanom, Thailand—June 2015 to June 2016: A prospective matched cohort study

Abstract

Background Frailty is associated with increased risk of mortality and decline in functional status among older adults. Older adults are at increased risk of severe disease from acute respiratory illness (ARIs), but ARI effects on frailty status among older adults are not well understood. We evaluated how ARIs affect short‐term frailty status among community‐dwelling adults aged ≥65 years in Nakhon Phanom, Thailand. Methods During May 2015 to May 2017, older adults were contacted weekly to identify ARIs as part of a community‐based longitudinal cohort study. Each participant's frailty status was assessed at baseline and every 6 months using the Vulnerable Elders Survey‐13 (VES‐13). We selected cohort participants with an ARI and compared them with a sample of participants without an ARI matched on age, sex, influenza vaccination status, and most recent VES‐13 score. For these matched cohort members, an additional VES‐13 was recorded at 3‐4 weeks after the ARI episode date. Results Of 3220 cohort study participants, 114 participants with an ARI and 111 comparison participants without an ARI were selected for the matched cohort; three comparison participants were matched to two ARI cases. We found no statistically significant difference between ARI and non‐ARI participants in modified VES‐13 score 3‐4 weeks post‐episode (cases = 0.90, controls = 0.63, P = 0.07). Only two ARI episodes required hospitalization. Conclusions Primarily mild ARIs did not affect short‐term frailty status among community‐dwelling older adults in Thailand. As few cases of severe ARI were detected, the contribution of severe ARI to changes in frailty requires further investigation.

Influenza infection is not associated with phenotypical frailty in older patients, a prospective cohort study

“…In a previous study of 114 patients using matched controls, the authors collected swabs in the community for general acute respiratory illness (but not specifically PCR diagnosed influenza). The authors found that influenza‐like symptoms were not associated with frailty as measured using the Vulnerable Elders Survey 13, which is a self‐report measure 26 . In a large Canadian survey study of participants with self‐reported influenza or influenza‐like illness, 40% indicated a recovery greater than two weeks, and long‐term function loss occurred in 3% by self‐report 27 .…”

“…The authors found that influenza‐like symptoms were not associated with frailty as measured using the Vulnerable Elders Survey 13, which is a self‐report measure. 26 In a large Canadian survey study of participants with self‐reported influenza or influenza‐like illness, 40% indicated a recovery greater than two weeks, and long‐term function loss occurred in 3% by self‐report. 27 This study was collected from a community cohort.…”

Fostering healthy aging: The interdependency of infections, immunity and frailty

“…Overall, pneumonia, influenza and varicella zoster infections appear to negatively affect physical function. Only two studies, one on pneumonia and one on varicella zoster infection, showed no association with reduced physical function ( Duracinsky et al, 2014 ; Hughes et al, 2019 ). The assessment of physical function greatly varied across studies, with most of them employing disability scores (e.g.…”