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Frailty transitions in older persons with lung function impairment : a population-based study

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Abstract
BACKGROUND: The ageing population and its burden on health-care systems warrant early detection of patients at risk of functional decline and mortality. We aimed to assess frailty transitions and its accuracy for mortality prediction in subjects with impaired spirometry (Preserved Ratio Impaired Spirometry [PRISm] or Chronic Obstructive Pulmonary Disease [COPD]).; METHODS: In participants from the population-based Rotterdam Study (mean age 69.1±8.9 years), we examined whether PRISm (Forced Expiratory Volume in 1 second [FEV1]/Forced Vital Capacity [FVC]≥70% and FEV1<80%) or COPD (FEV1/FVC<70%) affected frailty transitions (progression/recovery between frailty states [robust, prefrailty and frailty], lost to follow-up or death) using age-, sex- and smoking state-adjusted multinomial regression models yielding odd's ratios (OR). Second, we assessed diagnostic accuracy of frailty score for predicting mortality in subjects with COPD using c-statistics.; RESULTS: Compared to subjects with normal spirometry, subjects with PRISm were more likely to transit from robust (OR 2.2[1.2-4.2], p<0.05) or prefrailty (OR 2.6[1.3-5.5], p<0.01) towards frailty. Subjects with PRISm (OR 0.4[0.2-0.8], p<0.05) and COPD (OR 0.6[0.4-1.0], NS) were less likely to recover from their frail state, and were more likely to progress from any frailty state towards death (OR between 1.1 and 2.8, p<0.01). Accuracy for predicting mortality in subjects with COPD significantly improved when adding frailty score to age, sex and smoking status (90.5[82.3-89.8] vs 77.9[67.2-88.6], p<0.05).; CONCLUSION: Participants with PRISm or COPD more often developed frailty with poor reversibility. Assessing physical frailty improved risk stratification for subjects with impaired spirometry for predicting increased life years. © The Author(s) 2022. Published by Oxford University Press on behalf of The Gerontological Society of America.
Keywords
Epidemiology, Frailty, Pulmonary, Resilience, RISK-FACTORS, PREVALENCE, PATTERNS, OUTCOMES, ADULTS, COPD, MEN

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MLA
Wijnant, Sara, et al. “Frailty Transitions in Older Persons with Lung Function Impairment : A Population-Based Study.” JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES, vol. 78, no. 2, 2023, pp. 349–56, doi:10.1093/gerona/glac202.
APA
Wijnant, S., Benz, E., Luik, A. I., Rivadeneira, F., Voortman, T., Brusselle, G., & Lahousse, L. (2023). Frailty transitions in older persons with lung function impairment : a population-based study. JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES, 78(2), 349–356. https://doi.org/10.1093/gerona/glac202
Chicago author-date
Wijnant, Sara, Elizabeth Benz, Annemarie I Luik, Fernando Rivadeneira, Trudy Voortman, Guy Brusselle, and Lies Lahousse. 2023. “Frailty Transitions in Older Persons with Lung Function Impairment : A Population-Based Study.” JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES 78 (2): 349–56. https://doi.org/10.1093/gerona/glac202.
Chicago author-date (all authors)
Wijnant, Sara, Elizabeth Benz, Annemarie I Luik, Fernando Rivadeneira, Trudy Voortman, Guy Brusselle, and Lies Lahousse. 2023. “Frailty Transitions in Older Persons with Lung Function Impairment : A Population-Based Study.” JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES 78 (2): 349–356. doi:10.1093/gerona/glac202.
Vancouver
1.
Wijnant S, Benz E, Luik AI, Rivadeneira F, Voortman T, Brusselle G, et al. Frailty transitions in older persons with lung function impairment : a population-based study. JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES. 2023;78(2):349–56.
IEEE
[1]
S. Wijnant et al., “Frailty transitions in older persons with lung function impairment : a population-based study,” JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES, vol. 78, no. 2, pp. 349–356, 2023.
@article{01GJ30HERBN7NV1D65J9FCC7FP,
  abstract     = {{BACKGROUND: The ageing population and its burden on health-care systems warrant early detection of patients at risk of functional decline and mortality. We aimed to assess frailty transitions and its accuracy for mortality prediction in subjects with impaired spirometry (Preserved Ratio Impaired Spirometry [PRISm] or Chronic Obstructive Pulmonary Disease [COPD]).; METHODS: In participants from the population-based Rotterdam Study (mean age 69.1±8.9 years), we examined whether PRISm (Forced Expiratory Volume in 1 second [FEV1]/Forced Vital Capacity [FVC]≥70% and FEV1<80%) or COPD (FEV1/FVC<70%) affected frailty transitions (progression/recovery between frailty states [robust, prefrailty and frailty], lost to follow-up or death) using age-, sex- and smoking state-adjusted multinomial regression models yielding odd's ratios (OR). Second, we assessed diagnostic accuracy of frailty score for predicting mortality in subjects with COPD using c-statistics.; RESULTS: Compared to subjects with normal spirometry, subjects with PRISm were more likely to transit from robust (OR 2.2[1.2-4.2], p<0.05) or prefrailty (OR 2.6[1.3-5.5], p<0.01) towards frailty. Subjects with PRISm (OR 0.4[0.2-0.8], p<0.05) and COPD (OR 0.6[0.4-1.0], NS) were less likely to recover from their frail state, and were more likely to progress from any frailty state towards death (OR between 1.1 and 2.8, p<0.01). Accuracy for predicting mortality in subjects with COPD significantly improved when adding frailty score to age, sex and smoking status (90.5[82.3-89.8] vs 77.9[67.2-88.6], p<0.05).; CONCLUSION: Participants with PRISm or COPD more often developed frailty with poor reversibility. Assessing physical frailty improved risk stratification for subjects with impaired spirometry for predicting increased life years. © The Author(s) 2022. Published by Oxford University Press on behalf of The Gerontological Society of America.}},
  author       = {{Wijnant, Sara and  Benz, Elizabeth and  Luik, Annemarie I and  Rivadeneira, Fernando and  Voortman, Trudy and Brusselle, Guy and Lahousse, Lies}},
  issn         = {{1079-5006}},
  journal      = {{JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES}},
  keywords     = {{Epidemiology,Frailty,Pulmonary,Resilience,RISK-FACTORS,PREVALENCE,PATTERNS,OUTCOMES,ADULTS,COPD,MEN}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{349--356}},
  title        = {{Frailty transitions in older persons with lung function impairment : a population-based study}},
  url          = {{http://doi.org/10.1093/gerona/glac202}},
  volume       = {{78}},
  year         = {{2023}},
}

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