Abstract
BackgroundThe physical frailty status affects the health status of patients with chronic obstructive pulmonary disease (COPD). The objective was to determine if the individual physical frailty characteristics have a differential impact on the CAT score.MethodsThis observational study included 137 patients with stable COPD. Physical frailty was measured with unintentional weight loss, low physical activity, exhaustion, slow walking speed and low grip strength and health status assessed with the COPD Assessment test (CAT). The following variables were evaluated as potential determinants of CAT: sex, age, body mass index, smoking, dyspnea, exacerbations, comorbidities, %FEV1, %FVC, anxiety and depression.ResultsThe prevalence of characteristics for individual frailty was as follows: low grip strength, 60.6%; low physical activity, 27.0%; exhaustion, 19.7%; slow walking speed, 9.5%; and unintentional weight loss, 7.3%. A total of 17.5% of the patients were non-frail, 73.7% were pre-frail and only 8.7% were frail. One of the five frailty characteristics, exhaustion (adjusted β coefficient 5.12 [standard error = 1.27], p = 0.001) was an independent determinant of CAT score in the final regression model which was adjusted by other independent determinants of CAT (dyspnea, exacerbations and anxiety).ConclusionsDue to the fact that exhaustion is a frequent and relevant psychological symptom on CAT score of patients with COPD, interventions should reduce that stress. Future research should explore how exhaustion persists or remits over time.
Highlights
The physical frailty status affects the health status of patients with chronic obstructive pulmonary disease (COPD)
Airflow obstruction is a strong marker of disease, the most recent recommendations of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines indicate that the assessment and management of the disease
Regarding the prevalence of individual frailty characteristics, low grip strength was met by the largest proportion of patients in both the whole sample and the groups of pre-frail and frail patients (70.3 and 100% respectively) followed by low physical activity (25.7 and 91.7% respectively) and exhaustion (20.8 and 50%)
Summary
The physical frailty status affects the health status of patients with chronic obstructive pulmonary disease (COPD). The objective was to determine if the individual physical frailty characteristics have a differential impact on the CAT score. Chronic obstructive pulmonary disease (COPD) is characterized by persistent respiratory symptoms and airflow limitation usually caused by significant exposure to noxious particles or gases [1]. Several conceptual frameworks have been used for describing frailty in people with COPD [9, 11,12,13], the Fried phenotype model is the most usual According to this well-established and validated model, frailty encompasses five individual physical characteristics; unintentional weight loss, low physical activity, exhaustion, slow walking speed, and low grip strength [14]. In a recent systematic review, a percentage of 19% of patients with COPD were classified as frail and 56% were identified as pre-frail [15]
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