Impact of frailty in elderly patients with moderate to severe asthma

Figueiredo, Ricardo G.; Pinheiro, Gabriela Pimentel; Arata, V.; Leal2, Maisa F M; Santana, Cínthia Vila Nova; Tiraboschi, Taciana; Bessa, José de; Cruz, Álvaro Augusto

doi:10.1371/journal.pone.0270921

Cited by 4 publications

(5 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In this study, a high prevalence of frailty and pre-frailty was observed among older adults Chinese patients with asthma, suggesting that routine frailty assessment could benefit the management of asthma in this population. Evidence also supports the role of frailty as a significant risk factor for the development and progression of asthma (12). These findings underscore the potential for a bidirectional causal association between asthma and frailty, emphasizing the need to clarify this relationship to inform prevention and treatment strategies for both conditions.…”

Section: Introductionmentioning

confidence: 63%

The causal relationship between risk of developing bronchial asthma and frailty: a bidirectional two-sample Mendelian randomization study

Ma,

Xu,

Xie

et al. 2023

Front. Med.

View full text Add to dashboard Cite

BackgroundA potential link between asthma and frailty has been suggested in previous studies. However, the nature of the causal relationship between these two conditions warrants further investigation. Therefore, this study assessed the bidirectional causality between asthma and frailty risk using two-sample Mendelian randomization (MR).MethodsThe study data were obtained from the genome-wide association study (GWAS) dataset, with 337,159 samples representing asthma data and 175,226 samples representing frailty. The causal relationship between the two disorders was assessed by selecting the single nucleotide polymorphisms (SNPs), significantly associated with both asthma and frailty. The inverse variance weighting (IVW) method was used as the main analytical method to estimate the possible influence of causality. Sensitivity analysis was also performed using Mr-Egger intercept, funnel plot, “leave-one-out,” and Cochran Q test. In addition, potential mediators were investigated by risk factor analysis.ResultThe IVW method showed an increased risk of frailty due to increased genetic susceptibility factors and the number of to asthma (OR = 2.325, 95%CI:1.958–2.761; p = 6.527498e-22), while no horizontal pleiotropy was observed for the Mr-Egger intercept (p = 0.609) and the funnel plot. The Cochran Q value was 72.858, p = 0.024, and there was heterogeneity in the Cochran Q-value. No single SNP was observed for “leave-one-out” that had a biasing effect on the instrumental variables. In addition, genetic susceptibility to frailty was associated with asthma (OR = 1.088, 95%CI:1.058–1.119; p = 4.815589e-09). In the causal relationship described above, several risk factors for frailty are complex, with asthma leading to a significant reduction in physical activity endurance.ConclusionOur findings suggest a probable positive causal effect of asthma on the risk of developing frailty, potentially mediated by reduced physical activity endurance. At the same time, a causal relationship exists between frailty and asthma. Therefore, assessment strategies for frailty should include asthma and vice versa.

show abstract

Section: Introductionmentioning

confidence: 63%

The causal relationship between risk of developing bronchial asthma and frailty: a bidirectional two-sample Mendelian randomization study

Ma,

Xu,

Xie

et al. 2023

Front. Med.

View full text Add to dashboard Cite

show abstract

“…The recognition of asthma in ageing is frequently delayed and the treatment postponed due to difficulties that clinicians have in the approach in older asthmatic patient. Recently, a study protocol on the role of frailty in older patients with diagnosis of moderate-to-severe asthma according to guidelines [ 17 ] has been published by a group of researchers from Brazil, which may help characterise this group of patients [ 32 ]. A greater number of future studies and a multidisciplinary management of asthma in older adults are still needed.…”

Section: Discussionmentioning

confidence: 99%

Frailty Prevalence and Association with Clinical Outcomes in Interstitial Lung Disease, Asthma, and Pleural Disease

et al. 2023

View full text Add to dashboard Cite

Background: Frailty is a syndrome characterised by increased vulnerability to negative outcomes. Interstitial lung disease (ILD), asthma, and pleural disease are leading causes of morbidity and mortality. We aimed to investigate the prevalence and impact of frailty in adult patients with these diseases. Methods: We conducted a systematic review and meta-analysis, searching PubMed, Web of Science, The Cochrane Library, and EMBASE for studies reporting on frailty in ILD, asthma, and pleural disease. MeSH terms including interstitial lung disease, Idiopathic Pulmonary Fibrosis, Non-specific Interstitial Pneumonia, Chronic Hypersensitivity Pneumonitis, systemic sclerosis-associated ILD, connective tissue disease-associated ILD, and frailty were used as key words. The primary outcome was prevalence of frailty. Where enough contextually homogeneous studies were included, a pooled random-effects meta-analysis was performed with mortality and hospitalisation as the outcomes. Results: The review found three studies relating to frailty in asthma. No studies relating to pleural disease and frailty were identified. The median prevalence in asthma was 9.5% (IQR, 7.8–11.3). Six relevant studies incorporating 1471 ILD patients (age 68.3 ± SD2.38; 50% male) were identified, which were either cohort or cross-sectional design rated either good or fair. The median prevalence of frailty was 48% (IQR, 25–50). There was a positive association between frail ILD patients and increased risk of long-term mortality (pooled OR, 2.33 95%CI 1.31–4.15, I2 9%). One study reported a hospitalization rate of HR = 1.97(1.32–3.06) within 6 months in frail ILD patients. Conclusions: Frailty is very common and associated with increased mortality in patients with ILD. There are still minimal data regarding the prevalence of frailty and its influence on the risk in this population.

show abstract

“…Age-related changes in HRQoL experiences are variable such that significant constitutional heterogeneity exists among older patients from very “fit” to very “frail”. 61 Overall, frailty in gross and fine motor skills can affect asthma severity in elderly patients who struggle with hand eye coordination deficits possibly leading to ineffective use of prescribed inhalers. Neurocognitive impairments and decreased memory can affect the elderly in regular medication adherence, especially in the setting of polypharmacy.…”

Section: Th P: Problems For Elderly Asthmatics (Barriers Not Otherwis...mentioning

confidence: 99%

Asthma Care in the Elderly: Practical Guidance and Challenges for Clinical Management - A Framework of 5 “Ps”

Khosa

Louie

Moreno

et al. 2023

JAA

View full text Add to dashboard Cite

Uncontrolled asthma in the elderly is a public health issue recognized in developed countries such as the United States and among the European Union, both from patient safety and economic perspectives. Variations in the cutoff, which defines elderly age, contribute to epidemiological study difficulties. Nonetheless, the relevance of elderly asthma from a socioeconomic perspective is inarguable. The projected growth of the enlarging geriatric population in the United States portends an impending national health burden that may or may not be preventable with pharmacologic and non-pharmacologic treatments. Asthma in the elderly might be a consequence of uncontrolled disease that is carried throughout a lifetime. Or elderly asthmatics could suffer from uncontrolled asthma, which overlaps with other ailments common with advancing ages that merit consideration, eg, COPD, heart disease, OSA, diabetes mellitus, and other comorbidities. Because of the heterogeneity of asthma phenotypes and other conditions that could mimic the symptoms of elderly asthma, further cohort studies are needed to elucidate the elderly asthmatic pathophysiology and management. More studies to characterize elderly asthma can help address these patients' unmet need for evidence-based guidelines. We introduce the 5 "Ps" (phenotypes, partnership, pharmacology, practice in acute exacerbations, and problems or barriers for the elderly asthmatics) that establish a framework approach for clinical practice.

show abstract

Impact of frailty in elderly patients with moderate to severe asthma

Cited by 4 publications

References 31 publications

The causal relationship between risk of developing bronchial asthma and frailty: a bidirectional two-sample Mendelian randomization study

The causal relationship between risk of developing bronchial asthma and frailty: a bidirectional two-sample Mendelian randomization study

Frailty Prevalence and Association with Clinical Outcomes in Interstitial Lung Disease, Asthma, and Pleural Disease

Asthma Care in the Elderly: Practical Guidance and Challenges for Clinical Management - A Framework of 5 “Ps”

Contact Info

Product

Resources

About