Relationship between frailty, prognostic scores, and functional tests in elderly patients with chronic obstructive pulmonary disease
DOI:
https://doi.org/10.33448/rsd-v14i5.48743Keywords:
Clinical-Functional Vulnerability index-20; Frailty; Mortality; COPD.Abstract
Introduction: The aging of the population has raised concerns about the health conditions of the elderly and the relationship with their functional capacity. The present study aims to present an evaluation of the relationship between frailty and prognostic scores and functional tests in elderly patients with chronic obstructive pulmonary disease. The impact of frailty on the clinical and functional control of COPD has been investigated and there are already recommendations for early management of these patients. Methodology: Comparative analyses between the groups were performed using the unpaired t-test, Mann-Whitney test, Chi-square test and Chi-square test via Monte Carlo simulation, and Fisher's exact test. Brightness analyses between the Frailty Indicator (IVCF) and the other variables were performed using Pearson's Correlation Coefficient. A confidence level of 80% (CI80%) was chosen, corresponding to an α error of 0.20. This choice was motivated by the limitations of the reduced team and the short time available for data collection. Results: According to the data obtained, the increase in IVCF (greater frailty) was correlated with lower performance in the 6MWT (r=-0.35; p=0.041), lower FEV1 (r=-0.38; p=0.026) and reduction in total lung capacity (FVC) (r=-0.35; p=0.039). The IVCF also showed positive correlations between the presence of frailty and moderate to severe symptoms, with a higher CAT score (r=0.59; p=0.000) and worsening of the prognosis with higher numbers in the BODE index (r=0.35; p=0.038). Conclusion: Frail patients screened by IVCF have worse clinical and functional conditions than non-frail patients.
References
Antoniu, S. A., Boiculese, L. V., & Prunoiu, V. (2021). Frailty, a dimension of impaired functional status in advanced COPD: Utility and clinical applicability. Medicina, 57(5), 474. https://doi.org/10.3390/medicina57050474
Celli, B. R., Cote, C. G., Marin, J. M., Casanova, C., Montes de Oca, M., Mendez, R. A., Pinto Plata, V., & Cabral, H. J. (2004). The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. New England Journal of Medicine, 350(10), 1005–1012. https://doi.org/10.1056/NEJMoa021322
Cochran, W. G. (1967). Sampling techniques (3rd ed.). John Wiley & Sons.
Dlima, S., & Hall, A. (2024). Frailty: A global health challenge in need of local action. BMJ Global Health, 9(8), e015173. https://doi.org/10.1136/bmjgh-2024-015173
Dutta, S., Goel, N., & Kumar, R. (2023). Assessment of frailty and its predictors in chronic obstructive pulmonary disease. Lung India, 41(1), 17–24. https://doi.org/10.4103/lungindia.lungindia_286_23
Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD). (2025). Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease – update 2025. https://goldcopd.org/2025-gold-report/
Hanlon, P., et al. (2022). Frailty in COPD: An analysis of prevalence and clinical impact using UK Biobank. BMJ Open Respiratory Research, 9(1), e001314. https://doi.org/10.1136/bmjresp-2021-001314
CATestOnline.org. (2024). Clinical practice. https://www.catestonline.org/hcp-homepage/clinical-practice.html
Hoogendijk, E. O., Afilalo, J., Ensrud, K. E., Kowal, P., Onder, G., & Fried, L. P. (2019). Frailty: Implications for clinical practice and public health. The Lancet, 394(10206), 1365–1375. https://doi.org/10.1016/S0140-6736(19)31786-6
Instituto Brasileiro de Geografia e Estatística (IBGE). (2025). Censo Demográfico 2022. https://www.ibge.gov.br/estatisticas/sociais/trabalho/22827-censo-demografico2022.html
IVCF20. (2024). Geriatria e Gerontologia. https://www.ivcf20.org/
Kennedy, C., et al. (2018). Frailty and clinical outcomes in chronic obstructive pulmonary disease. Annals of the American Thoracic Society, 16, 217–224. https://doi.org/10.1513/AnnalsATS.201806-399OC
Maddocks, M., et al. (2023). Rehabilitation for people with respiratory disease and frailty: An official American Thoracic Society workshop report. Annals of the American Thoracic Society, 20(6), 767–780. https://doi.org/10.1513/AnnalsATS.202302-138WS
Moraes, E. N., et al. (2016). Índice de Vulnerabilidade Clínico Funcional-20 (IVCF-20): Reconhecimento rápido do idoso frágil. Revista de Saúde Pública, 50, 81. https://doi.org/10.1590/S1518-8787.2016050006963
Naval, E., et al. (2021). Frailty assessment in a stable COPD cohort: Is there a COPD-frail phenotype? COPD: Journal of Chronic Obstructive Pulmonary Disease, 18(5), 525–532. https://doi.org/10.1080/15412555.2021.1959619
Organização das Nações Unidas (ONU). (2024). World population prospects 2024: Summary of results. https://desapublications.un.org/publications/world-population-prospects-2024-summary-results
Organização Mundial da Saúde (OMS). (2024). Chronic obstructive pulmonary disease (COPD). https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd)
Pereira, A.S. et al. (2018). Metodologia da pesquisa científica. [free e-book]. Ed. UFSM.
Pereira, M. G. (2005). Epidemiologia: Teoria e prática (pp. 337–357). Guanabara Koogan.
Scarlata, S., et al. (2021). Association between frailty index, lung function, and major clinical determinants in chronic obstructive pulmonary disease. Aging Clinical and Experimental Research, 33(8), 2165–2173. https://doi.org/10.1007/s40520-020-01742-7
Scheaffer, R. L., Mendenhall, W., & Ott, L. (1990). Elementary survey sampling. Duxbury Press.
Shitsuka et al. (2014). Matemática fundamental para a tecnologia. São Paulo: Ed. Érica.
Tarazona-Santabalbina, F. J., et al. (2023). Is frailty diagnosis important in patients with COPD? A narrative review of the literature. International Journal of Environmental Research and Public Health, 20(3), 1678. https://doi.org/10.3390/ijerph20031678
Verduri, A., et al. (2024). Impact of frailty on symptom burden in chronic obstructive pulmonary disease. Journal of Clinical Medicine, 13(4), 984. https://doi.org/10.3390/jcm13040984
Vieira, S. (2021). Introdução à bioestatística. Ed.GEM/Guanabara Koogan.
Xue, Q.-L., Bandeen-Roche, K., Tian, J., & Fried, L. P. (2021). Progression of physical frailty and the risk of all‐cause mortality: Is there a point of no return? Journal of the American Geriatrics Society, 69(4), 908–915. https://doi.org/10.1111/jgs.17009
Wang, L., Zhang, X., & Liu, X. (2023). Prevalence and clinical impact of frailty in COPD: A systematic review and meta-analysis. BMC Pulmonary Medicine, 23(1), 1–12. https://doi.org/10.1186/s12890-023-02444-1
Yee, N., et al. (2020). Frailty in chronic obstructive pulmonary disease and risk of exacerbations and hospitalizations. International Journal of Chronic Obstructive Pulmonary Disease, 15, 1967–1976. https://doi.org/10.2147/COPD.S254230
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Copyright (c) 2025 Aline Mansur da Costa Reis; Fernanda Brito de Oliveira; Junia Rios Garib; Natália Braga de Gouvêa; Paulo de Mello Bolonetti
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