Frailty in older patients with chronic obstructive pulmonary disease (COPD) undergoing a multidisciplinary rehabilitation

BACKGROUND: Chronic obstructive pulmonary disease (COPD) can be associated with cognitive impairment, psychological distress, reduced Health-Related Quality of Life (HRQoL) and worsening in functional abilities. Frailty syndrome, which mostly coexists with COPD, can further exacerbate these clinical conditions. This study aims to analyze multidimensional clinical, functional, psychological characteristics, and frailty, in older patients with COPD at the admission to a pulmonary rehabilitation program. The study also looks forward to investigating potential relationships between these variables and to identify eventual predictors of frailty. METHODS: This is a cross-sectional study. Hospitalized patients aged >= 65 with COPD were enrolled in a multidisciplinary rehabilitation program and underwent to a comprehensive assessment on disease-related clinical characteristics (such as cognitive and executive functions, anxiety, and depression, HRQoL, frailty, functional variables, and blood tests). RESULTS: 133 COPD patients were included in the study. The mean Forced Expiratory Volume in 1 second (FEV1%) was 49.89 +/- 15.18, and the mean age was 73.82 +/- 5.90. Among the participants, 21.8% were identified as frail based on the Clinical Frailty Scale (CFS >= 5), and nearly a quarter of the sample showed impaired scores in the cognitive evaluation. Symptoms of anxiety and depression were reported by 11.27% and 18.04% of the patients. Frailty was found to be associated with functional variables, HRQoL, and self-reported adherence. Hemoglobin levels, Barthel Index, and self-reported adherence were identified as predictors of frailty. CONCLUSIONS: This study highlights the importance of a multidimensional assessment, with a specific focus on frailty, in an interdisciplinary setting for older patients with COPD. This kind of assessment provides information to tailor and individualize rehabilitation interventions.