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Background: Despite frailty being an important geriatric syndrome, its prevalence and associated mortality risk in older patients with chronic obstructive pulmonary disease (COPD) are unknown. Methods: We examined the relationship between COPD confirmed by spirometry, COPD severity, and frailty defined by the Fried criteria within 2,142 participants (aged 74.7 +/- 5.6 years) of the Rotterdam Study, a prospective population-based cohort study. Results: The frailty prevalence was significantly higher (p < .001) in participants with COPD (10.2%, 95% CI: 7.6%-13.5%) compared with participants without COPD (3.4%, 95% CI: 2.6%-4.4%). Adjusted for age, sex, smoking, corticosteroids, and other confounders, participants with COPD had a more than twofold increased prevalence of frailty (odds ratio 2.2, 95% CI: 1.34-3.54, p = .002). The prevalence was highest when severe airflow limitation, dyspnea, and frequent exacerbations were present. Participants with mild airflow limitation were more frequently prefrail. COPD elderly who were frail had significant worse survival. Conclusions: This population-based cohort study in elderly demonstrates that COPD is associated with frailty even after adjusting for shared risk factors. Our findings suggest that frailty-in addition to COPD severity and comorbidities-identifies those COPD participants at high risk of mortality.
Keywords
Chronic obstructive pulmonary disease, Epidemiology, Frailty, Multimorbidities, Mortality, Pulmonary, OBSTRUCTIVE PULMONARY-DISEASE, GERIATRIC SYNDROME, INFLAMMATION, COMORBIDITIES, COAGULATION, ROTTERDAM, MORTALITY, INTERLEUKIN-6, ACTIVATION, PREVENTION

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Chicago
Lahousse, Lies, Gijsbertus Ziere, Vincentius JA Verlinden, M Carola Zillikens, André G Uitterlinden, Fernando Rivadeneira, Henning Tiemeier, et al. 2016. “Risk of Frailty in Elderly with COPD : a Population-based Study.” Journals of Gerontology Series A-biological Sciences and Medical Sciences 71 (5): 689–695.
APA
Lahousse, L., Ziere, G., Verlinden, V. J., Zillikens, M. C., Uitterlinden, A. G., Rivadeneira, F., Tiemeier, H., et al. (2016). Risk of frailty in elderly with COPD : a population-based study. JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES, 71(5), 689–695.
Vancouver
1.
Lahousse L, Ziere G, Verlinden VJ, Zillikens MC, Uitterlinden AG, Rivadeneira F, et al. Risk of frailty in elderly with COPD : a population-based study. JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES. 2016;71(5):689–95.
MLA
Lahousse, Lies, Gijsbertus Ziere, Vincentius JA Verlinden, et al. “Risk of Frailty in Elderly with COPD : a Population-based Study.” JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES 71.5 (2016): 689–695. Print.
@article{7089603,
  abstract     = {Background: Despite frailty being an important geriatric syndrome, its prevalence and associated mortality risk in older patients with chronic obstructive pulmonary disease (COPD) are unknown. 
Methods: We examined the relationship between COPD confirmed by spirometry, COPD severity, and frailty defined by the Fried criteria within 2,142 participants (aged 74.7 +/- 5.6 years) of the Rotterdam Study, a prospective population-based cohort study. 
Results: The frailty prevalence was significantly higher (p {\textlangle} .001) in participants with COPD (10.2\%, 95\% CI: 7.6\%-13.5\%) compared with participants without COPD (3.4\%, 95\% CI: 2.6\%-4.4\%). Adjusted for age, sex, smoking, corticosteroids, and other confounders, participants with COPD had a more than twofold increased prevalence of frailty (odds ratio 2.2, 95\% CI: 1.34-3.54, p = .002). The prevalence was highest when severe airflow limitation, dyspnea, and frequent exacerbations were present. Participants with mild airflow limitation were more frequently prefrail. COPD elderly who were frail had significant worse survival. 
Conclusions: This population-based cohort study in elderly demonstrates that COPD is associated with frailty even after adjusting for shared risk factors. Our findings suggest that frailty-in addition to COPD severity and comorbidities-identifies those COPD participants at high risk of mortality.},
  author       = {Lahousse, Lies and Ziere, Gijsbertus and Verlinden, Vincentius JA and Zillikens, M Carola and Uitterlinden, Andr{\'e} G and Rivadeneira, Fernando and Tiemeier, Henning and Joos, Guy and Hofman, Albert and Ikram, M Arfan and Franco, Oscar H and Brusselle, Guy and Stricker, Bruno H},
  issn         = {1079-5006},
  journal      = {JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES},
  keyword      = {Chronic obstructive pulmonary disease,Epidemiology,Frailty,Multimorbidities,Mortality,Pulmonary,OBSTRUCTIVE PULMONARY-DISEASE,GERIATRIC SYNDROME,INFLAMMATION,COMORBIDITIES,COAGULATION,ROTTERDAM,MORTALITY,INTERLEUKIN-6,ACTIVATION,PREVENTION},
  language     = {eng},
  number       = {5},
  pages        = {689--695},
  title        = {Risk of frailty in elderly with COPD : a population-based study},
  url          = {http://dx.doi.org/10.1093/gerona/glv154},
  volume       = {71},
  year         = {2016},
}

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