Prevalence and prognostic impact of physical frailty in interstitial lung disease: A prospective cohort study
Mohammed A. Malik Farooqi
Department of Medicine, Division of Respirology, McMaster University, Hamilton, Ontario, Canada
Firestone Institute for Respiratory Health and St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
Contribution: Conceptualization, Formal analysis, Methodology, Writing - original draft
Search for more papers by this authorSachi O'Hoski
School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
Contribution: Conceptualization, Methodology, Validation, Writing - original draft
Search for more papers by this authorSarah Goodwin
Firestone Institute for Respiratory Health and St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
Contribution: Data curation, Writing - review & editing
Search for more papers by this authorNima Makhdami
Firestone Institute for Respiratory Health and St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
Contribution: Data curation, Writing - review & editing
Search for more papers by this authorAfia Aziz
Firestone Institute for Respiratory Health and St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
Contribution: Data curation, Writing - review & editing
Search for more papers by this authorGerard Cox
Department of Medicine, Division of Respirology, McMaster University, Hamilton, Ontario, Canada
Firestone Institute for Respiratory Health and St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
Contribution: Methodology, Supervision, Writing - review & editing
Search for more papers by this authorJoshua Wald
Department of Medicine, Division of Respirology, McMaster University, Hamilton, Ontario, Canada
Firestone Institute for Respiratory Health and St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
Contribution: Conceptualization, Writing - review & editing
Search for more papers by this authorChristopher J. Ryerson
Department of Medicine, University of British Columbia & Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, British Columbia, Canada
Contribution: Conceptualization, Data curation, Methodology, Supervision, Writing - review & editing
Search for more papers by this authorMarla K. Beauchamp
Department of Medicine, Division of Respirology, McMaster University, Hamilton, Ontario, Canada
School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
Contribution: Conceptualization, Methodology, Supervision, Validation, Writing - review & editing
Search for more papers by this authorNathan Hambly
Department of Medicine, Division of Respirology, McMaster University, Hamilton, Ontario, Canada
Firestone Institute for Respiratory Health and St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
Contribution: Conceptualization, Supervision, Writing - original draft, Writing - review & editing
Search for more papers by this authorCorresponding Author
Martin Kolb
Department of Medicine, Division of Respirology, McMaster University, Hamilton, Ontario, Canada
Firestone Institute for Respiratory Health and St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
Correspondence
Martin Kolb, Department of Medicine, Firestone Institute for Respiratory Health and St Joseph's Healthcare Hamilton, T2117 50 Charlton Ave. E., Hamilton, ON L8N 4A6, Canada.
Email: [email protected]
Contribution: Conceptualization, Supervision, Writing - review & editing
Search for more papers by this authorMohammed A. Malik Farooqi
Department of Medicine, Division of Respirology, McMaster University, Hamilton, Ontario, Canada
Firestone Institute for Respiratory Health and St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
Contribution: Conceptualization, Formal analysis, Methodology, Writing - original draft
Search for more papers by this authorSachi O'Hoski
School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
Contribution: Conceptualization, Methodology, Validation, Writing - original draft
Search for more papers by this authorSarah Goodwin
Firestone Institute for Respiratory Health and St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
Contribution: Data curation, Writing - review & editing
Search for more papers by this authorNima Makhdami
Firestone Institute for Respiratory Health and St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
Contribution: Data curation, Writing - review & editing
Search for more papers by this authorAfia Aziz
Firestone Institute for Respiratory Health and St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
Contribution: Data curation, Writing - review & editing
Search for more papers by this authorGerard Cox
Department of Medicine, Division of Respirology, McMaster University, Hamilton, Ontario, Canada
Firestone Institute for Respiratory Health and St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
Contribution: Methodology, Supervision, Writing - review & editing
Search for more papers by this authorJoshua Wald
Department of Medicine, Division of Respirology, McMaster University, Hamilton, Ontario, Canada
Firestone Institute for Respiratory Health and St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
Contribution: Conceptualization, Writing - review & editing
Search for more papers by this authorChristopher J. Ryerson
Department of Medicine, University of British Columbia & Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, British Columbia, Canada
Contribution: Conceptualization, Data curation, Methodology, Supervision, Writing - review & editing
Search for more papers by this authorMarla K. Beauchamp
Department of Medicine, Division of Respirology, McMaster University, Hamilton, Ontario, Canada
School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
Contribution: Conceptualization, Methodology, Supervision, Validation, Writing - review & editing
Search for more papers by this authorNathan Hambly
Department of Medicine, Division of Respirology, McMaster University, Hamilton, Ontario, Canada
Firestone Institute for Respiratory Health and St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
Contribution: Conceptualization, Supervision, Writing - original draft, Writing - review & editing
Search for more papers by this authorCorresponding Author
Martin Kolb
Department of Medicine, Division of Respirology, McMaster University, Hamilton, Ontario, Canada
Firestone Institute for Respiratory Health and St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
Correspondence
Martin Kolb, Department of Medicine, Firestone Institute for Respiratory Health and St Joseph's Healthcare Hamilton, T2117 50 Charlton Ave. E., Hamilton, ON L8N 4A6, Canada.
Email: [email protected]
Contribution: Conceptualization, Supervision, Writing - review & editing
Search for more papers by this authorAbstract
Background and objective
Physical frailty is associated with increased mortality and hospitalizations in older adults. We describe the prevalence of physical frailty and its prognostic impact in patients with a spectrum of fibrotic interstitial lung disease (ILD).
Methods
Patients with fibrotic ILD at the McMaster University ILD programme were prospectively followed up from November 2015 to March 2020. Baseline data were used to classify patients as non-frail (score = 0), pre-frail (score = 1–2) or frail (score = 3–5) based on modified Fried physical frailty criteria. The association between physical frailty and mortality was assessed using time-to-event models, adjusted for age, sex, lung function and diagnosis using the ILD Gender–Age–Physiology (ILD-GAP) score.
Results
We included 463 patients (55% male, mean [SD] age 68 [11] years); 82 (18%) were non-frail, 258 (56%) pre-frail and 123 (26%) frail. The most common ILD diagnoses were idiopathic pulmonary fibrosis (n = 183, 40%) and connective tissue disease-associated-ILD (n = 79, 17%). Mean time since diagnosis was 2.7 ± 4.6 years. There were 56 deaths within the median follow-up of 1.71 (interquartile range [IQR] 1.24, 2.31) years. Both frail and pre-frail individuals had a higher risk of death compared to those categorized as non-frail at baseline (adjusted hazard ratio [aHR] 4.14, 95% CI 1.27–13.5 for pre-frail and aHR 4.41, 95% CI 1.29–15.1 for frail).
Conclusion
Physical frailty is prevalent in patients with ILD and is independently associated with an increased risk of death. Assessment of physical frailty provides additional prognostic value to recognized risk scores such as the ILD-GAP score, and may present a modifiable target for intervention.
CONFLICT OF INTEREST
The authors declare that they have no conflicts of interest.
Supporting Information
| Filename | Description |
|---|---|
| resp14066-sup-0001-supinfo.pdfPDF document, 140.9 KB | Visual Abstract Prevalence and prognostic impact of physical frailty in Interstitial Lung Disease: A prospective cohort study |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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