Abstract Background Frailty is a dynamic concept that provide a more comprehensive assessment of biological reserve and functional status rather than chronological age alone. The aim of this study is to evaluate the prevalence of frailty and to analyse the factors associated with this condition in elderly inflammatory bowel disease (IBD) patients. Methods As part of the Astur-Frailty-IBD study (a multicentre prospective study of elderly IBD patients attended at three hospitals in Asturias, Spain), we present the baseline data of the cohort. We recruited all consecutive IBD patients ≥ 60 years during outpatient visits between March 1 and June 30, 2024. Demographic data and clinical characteristics of IBD were collected from the medical records and disease activity was assessed using clinical scores and biomarkers. All the patients were surveyed by face-to-face questionaries. Frailty was assessed using the Fried Frailty Phenotype which defines non-frail (0 criteria), prefrail (1-2), and frail phenotype (≥ 3 criteria). Comorbidity was assessed using Charlson Comorbidity Index (CCI) and Cumulative Illness Rating Scale-Geriatric (CIRS-G). Univariable and multivariable ordinal logistic regression model was performed. Results A total of 612 IBD patients (median age 68.8 years, 50.2% females, 56.4% Crohn’s disease, median duration of the disease 15 years) were included in our study. One hundred and three (16.8%) patients were considered frail, 302 (49.3%) prefrail and 207 (33.8%) non-frail. Association of demographic, social and clinical factors according to different frailty levels are shown in Table 1. Univariate analysis showed the factors that are independently associated with increased risk of frailty were higher age, female gender, higher BMI, osteoarticular disease, polypharmacy, clinical activity, faecal calprotectin ≥ 250 μg/g, currently use of steroids, immunomodulator, or biologics, CCI ≥4, and CIRS-G ≥ 3. In contrast, ulcerative colitis, IBD-Unclassified and having good family support were associated with a lower risk of frailty (p=0.02). On multivariate analysis, higher age, female gender, family support, osteoarticular disease, both axial and peripheral, polypharmacy, clinical activity, currently use of steroids, and CIRS-G ≥ 3 were independent predictors of increased risk of frailty. The strongest predictor of risk of frailty was the clinical activity. These results are presented in table 2. Conclusion In our cohort, higher age, female gender, poor family support, osteoarticular disease, polypharmacy, clinical activity, current use of steroids, and CIRS-G ≥ 3 are independent predictors of increased risk of frailty.
Read full abstract