Prevalence and risk factors of frailty in patients with chronic obstructive pulmonary disease: systematic review and meta-analysis

Abstract

Objective To systematically review the prevalence and risk factors for frailty in patients with chronic obstructive pulmonary disease (COPD). Methods A systematic review and meta-analysis were conducted, and a search of the PubMed, Embase and Web of Science databases was carried out to collect Chinese and English studies on frailty and COPD published up to September 5, 2022. Results A total of 38 articles were included for the quantitative analysis after the collected literature was either included or omitted based on pertinent criteria. The results indicated that the estimated overall pooled prevalence of frailty was 36% (95% confidence interval [CI] = 31–41%), and the estimated pre-frailty was 43% (95% CI = 37–49%). A higher age (odds ratio [OR] = 1.04; 95% CI = 1.01–1.06) and higher COPD assessment test (CAT) score (OR = 1.19; 95% CI = 1.12–1.27) were associated with a significantly increased likelihood of frailty in patients with COPD. However, a higher educational attainment (OR = 0.55; 95% CI = 0.43–0.69) and higher income (OR = 0.63; 95% CI = 0.45–0.88) were associated with a significantly reduced risk of frailty in patients with COPD. A total of 17 other risk factors for frailty were identified via qualitative synthesis. Conclusion The incidence of frailty in patients with COPD is high, and there are many influencing factors.

Effects of cigarette smoking and secondhand smoke exposure on physical frailty development among community‐dwelling older adults in Japan: Evidence from a 10‐year population‐based cohort study

“…Also, previous studies and meta‐analyses showed that there was a significantly increased likelihood of frailty in patients with chronic bronchitis or chronic obstructive pulmonary disease, and chronic obstructive pulmonary disease is a common chronic disease among people with a smoking habit. This evidence suggests that there is a possible link between smoking and frailty 23 …”

“…This evidence suggests that there is a possible link between smoking and frailty. 23 However, most studies on secondhand smoke exposure and frailty are cross-sectional, and the additive effect of secondhand smoke exposure on cigarette smoking is still unknown. Thus, this 10-year longitudinal prospective cohort study explored the relationship between smoking and secondhand smoke and the incidence of physical frailty among community-dwelling older adults in Japan.…”

Frailty and Exacerbation of Chronic Obstructive Pulmonary Disease: Is There Any Association?

“…A number of cross-sectional studies have demonstrated the discriminative property of frailty in subjects with COPD. [4][5][6][7] A previous study noted that COPD patient with frailty may respond well to pulmonary rehabilitation, one of the standard treatments for COPD, but subsequently experience rapid deterioration of their disease, especially after the end of rehabilitation. [8][9][10][11] Therefore, the predictive property of frailty is still an important research question.…”

Association of Frailty with Patient-Report Outcomes and Major Clinical Determinants in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

“…Moreover, these patients were more likely to have deficits in muscle strength and mass. [42][43][44][45] As the level of dyspnea increases, the patient's physical activity decreases, which increases the likelihood of muscle atrophy and loss of muscle strength, further contributing to a decrease in the patient's activity tolerance. 42 Exercise training is an important component of pulmonary rehabilitation for patients with COPD.…”

“…[42][43][44][45] As the level of dyspnea increases, the patient's physical activity decreases, which increases the likelihood of muscle atrophy and loss of muscle strength, further contributing to a decrease in the patient's activity tolerance. 42 Exercise training is an important component of pulmonary rehabilitation for patients with COPD. 45 As evidenced by multiple studies, [46][47][48] exercise training is effective in reversing the systemic consequences of COPD, particularly skeletal muscle dysfunction, 46 improving exercise tolerance, reducing symptoms of dyspnea, and increasing the HRQoL of patients with COPD.…”