Frailty and geriatric conditions in older patients with idiopathic pulmonary fibrosis

Respir Med. 2019 Mar:148:6-12. doi: 10.1016/j.rmed.2019.01.008. Epub 2019 Jan 24.

Abstract

Background: Functional status, an important predictor of health outcomes in older patients, has not been studied in an IPF population. This study aimed to determine the prevalence of frailty and geriatric conditions in older patients with IPF.

Methods: IPF patients age ≥65 years were identified prospectively at the University of Michigan. Frailty was assessed using the Fried frailty phenotype. Questionnaires addressing functional status, geriatric conditions and symptoms were administered. Quantitative measurement of pectoralis muscle area was performed. Patient variables were compared among different frailty groups.

Results: Of the 50 participants, 48% were found to be frail and 40% had ≥2 geriatric conditions. Frailty was associated with increased age, lower lung function, shorter 6-min walk distance, higher symptom scores and a greater number of comorbidities, geriatric conditions and functional limitations (p < 0.05). Pectoralis muscle area was nearly significant (p = 0.08). Self-reported fatigue score (odds ratio [OR] = 2.13, confidence interval [CI] 95% 1.23-3.70, p = 0.0068) and diffusion capacity (OR = 0.54 CI 95% 0.35-0.85, p = 0.0071) were independent predictors of frailty.

Conclusions: Frailty and geriatric conditions are common in older patients with IPF. The presence of frailty was associated with objective (diffusion capacity) and subjective (self-reported fatigue score) data. Longitudinal evaluation is necessary to determine impact of frailty on disease-related outcomes in IPF.

Keywords: Body composition; Frailty; Geriatric conditions; Idiopathic pulmonary fibrosis.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Body Composition / physiology
  • Comorbidity
  • Cross-Sectional Studies
  • Fatigue / epidemiology*
  • Fatigue / psychology
  • Female
  • Frailty / complications*
  • Frailty / epidemiology
  • Geriatric Assessment
  • Humans
  • Idiopathic Pulmonary Fibrosis / epidemiology*
  • Idiopathic Pulmonary Fibrosis / physiopathology
  • Male
  • Pectoralis Muscles / diagnostic imaging*
  • Predictive Value of Tests
  • Prevalence
  • Prospective Studies
  • Pulmonary Diffusing Capacity / methods
  • Respiratory Function Tests / methods
  • Walk Test / methods