Frailty and respiratory impairment in older persons
Open accessAbstract
Background Among older persons, the association between frailty and spirometry-confirmed respiratory impairment has not been evaluated yet.Methods By using data on white participants aged 65 to 80 years (Cardiovascular Health Study, N=3578), we evaluated cross-sectional and longitudinal associations between frailty and respiratory impairment, including their combined effect on mortality. Baseline assessments included frailty status (Fried phenotype: non-frail, pre-frail, and frail) and spirometry. Outcomes included development of frailty features (pre-frail or frail) at year 3 and respiratory impairment (airflow limitation or restrictive pattern) at year 4, and death (median follow-up, 13.2 years).Results At baseline, 48.3% of participants were pre-frail, 5.8% of participants were frail, 13.8% of participants had airflow limitation, and 9.3% of participants had restrictive pattern; 46.1% of participants subsequently died. At baseline, pre-frail and frail were cross-sectionally associated with airflow limitation (adjusted odds ratio [OR], 1.62; 95% confidence interval [CI], 1.29-2.04 and adjusted OR 1.88; 95% CI, 1.15-3.09) and restrictive pattern (adjusted OR, 1.80; 95% CI, 1.37-2.36 and adjusted OR, 3.05; 95% CI, 1.91-4.88), respectively. Longitudinally, participants with baseline frailty features had an increased likelihood of developing respiratory impairment (adjusted OR, 1.42; 95% CI, 1.11-1.82). Conversely, participants with baseline respiratory impairment had an increased likelihood of developing frailty features (adjusted OR, 1.58; 95% CI, 1.17-2.13). Mortality was highest among participants who were frail and had respiratory impairment (adjusted hazard ratio, 3.91; 95% CI, 2.93-5.22), compared with those who were non-frail and had no respiratory impairment.Conclusion Frailty and respiratory impairment are strongly associated with one another and substantially increase the risk of death when both are present. Establishing these associations may inform interventions designed to reverse or prevent the progression of either condition and to reduce adverse outcomes.
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Frailty has additionally been linked to reduced reserve in respiratory, cardiovascular, renal, blood and clotting systems, with nutrition possibly acting as a mediator.
“it is important to recognise that frailty has also been associated with loss of physiological reserve in the respiratory (15), cardiovascular (16), renal (17) and haemopoietic and clotting systems (18, 19) and that nutritional status can also be a mediating factor (3, 20-22).”
From Frailty in elderly people (2013) · cites this paper as [15]
Pulmonary function is associated with frailty.
“Pulmonary function is associated with frailty (15)”
From Frailty in elderly people (2013) · cites this paper as [15]
Pulmonary function may have utility as a straightforward detection test for frailty.
“and may have utility as a straightforward detection test.”
From Frailty in elderly people (2013) · cites this paper as [15]
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- Authors
- Vaz Fragoso, C. A., Enright, P. L., McAvay, G., Van Ness, P. H., & Gill, T. M.
- Affiliations
- University of Arizona (US)
- Yale University (US)
- Venue
- The American Journal of Medicine
- Publisher
- Elsevier BV
- Published
- 2012-01
- Volume
- 125
- Issue
- 1
- Pages
- 79-86
- ISSN
- 0002-9343 (ISSN-L)
- PMC
- PMC3246194
- OpenAlex
- W2062841474
- Cited by
- 191
- References
- 47
- Citations by year
- 2026: 12 · 2025: 13 · 2024: 16 · 2023: 15 · 2022: 21 · 2021: 14 · 2020: 19 · 2019: 11 · 2018: 14 · 2017: 12 · 2016: 11 · 2015: 11 · 2014: 6 · 2013: 8 · 2012: 7
- FWCI
- 3.35
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- The American Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (R03AG037051)
- U.S. Department of Veterans Affairs
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Keywords
- frailty, respiratory dysfunction, older adults, airflow obstruction, restrictive lung pattern, pre-frailty, mortality, Fried frailty phenotype, spirometry, Cardiovascular Health Study, lung function decline, cardiovascular risk factors, diabetes mellitus, physical activity, body mass index
- MeSH terms
- Aged, Aged, 80 and over, Cross-Sectional Studies, Female, Humans, Longitudinal Studies, Male, Respiratory Insufficiency, Spirometry, United States, Frail Elderly
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