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Observational Study
. 2023 May-Jun:59:88-94.
doi: 10.1016/j.hrtlng.2023.01.020. Epub 2023 Feb 14.

Pulmonary function is associated with frailty, hospitalization and mortality in older people: 5-year follow-up

Walter Sepúlveda-Loyola  1 , Jose A Carnicero  2 , Alejandro Álvarez-Bustos  3 , Vanessa Suziane Probst  4 , Francisco J Garcia-Garcia  5 , Leocadio Rodriguez-Mañas  6
Affiliations
Observational Study

Pulmonary function is associated with frailty, hospitalization and mortality in older people: 5-year follow-up

Walter Sepúlveda-Loyola et al. Heart Lung. 2023 May-Jun.

Abstract

Background: The relationship between pulmonary impairment and frailty has rarely been studied in community-dwelling older adults.

Objective: This study aimed to analyze the association between pulmonary function and frailty (prevalent and incident), identifying the best cut-off points to detect frailty and its association with hospitalization and mortality.

Methods: A longitudinal observational cohort study with 1188 community-dwelling older adults was taken from the Toledo Study for Healthy Aging. The forced expiratory volume in the first second (FEV1) and the forced vital capacity (FVC) were measured with spirometry. Frailty was evaluated using the Frailty Phenotype and Frailty Trait Scale 5. Associations between pulmonary function and frailty, hospitalization and mortality in a 5-year follow-up and the best cut-off points for FEV1 and FVC were analyzed.

Results: FEV1 and FVC were associated with frailty prevalence (OR from 0.25 to 0.60), incidence (OR from 0.26 to 0.53), and hospitalization and mortality (HR from 0.35 to 0.85). The cut-off points of pulmonary function identified in this study: FEV1 (≤1.805 L for male and ≤1.165 L for female) and FVC (≤2.385 L for male and ≤1.585 L for female) were associated with incident frailty (OR: 1.71-4.06), hospitalization (HR: 1.03-1.57) and mortality (HR: 2.64-5.17) in individuals with and without respiratory diseases (P < 0.05 for all).

Conclusion: Pulmonary function was inversely associated with the risk of frailty, hospitalization and mortality in community-dwelling older adults. The cut-off points for FEV1 and FVC to detect frailty were highly associated with hospitalization and mortality in the 5-year follow-up, regardless of the existence of pulmonary diseases.

Keywords: Aging; Cut-point; Frailty syndrome; Older adults; Public health; Respiratory function test.

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Conflict of interest statement

Declaration of Competing Interest We declare no financial support or relationships that may pose conflict of interest. Additionally, the present study was approved by the Clinical Research Ethics Committee of the Toledo Hospital, Spain. Participants signed the informed consent. This work was supported by grants from the Spanish Ministry of Economy, Industry and Competitiveness, financed by the European Regional Development Funds and the Centro de Investigación Biomédica en Red en Fragilidad y Envejecimiento Saludable (CB16/10/00464), and the Fundación Francisco Soria Melguizo (Section 2/2020). The research leading to these results has also received support from the Innovative Medicines Initiative Joint Undertaking under grant agreement n◦115621, resources of which are composed of financial contribution from the European Union’ Seventh Framework Programme (FP7/2007–2013) and EFPIA companies’ in-kind contribution. This funding sources had no role in the design of the study, its execution, analyses and data interpretation or decision to submit results. WSL was supported by the Brazilian National Council for Scientific and Technological Development (CNPq).

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