Breathlessness, Frailty, and Sarcopenia in Older Adults

被引：7

作者：

An, Tai Joon ^{[1
]}

Lim, Jihye ^{[2
]}

Lee, Heayon ^{[3
,4
]}

Ji, Sunghwan ^{[5
,6
]}

Jung, Hee-Won ^{[5
,6
]}

Baek, Ji Yeon ^{[5
,6
]}

Lee, Eunju ^{[5
,6
]}

Jang, Il-Young ^{[5
,6
,7
,8
]}

机构：

[1] Catholic Univ Korea, Div Pulm & Crit Care Med, Seoul, South Korea

[2] Catholic Univ Korea, Yeouido St Marys Hosp, Dept Internal Med, Div Gastroenterol & Hepatol,Coll Med, Seoul, South Korea

[3] Catholic Univ Korea, Yeouido St Marys Hosp, Coll Med, Dept Internal Med, Seoul, South Korea

[4] Catholic Univ Korea, Yeouido St Marys Hosp, Coll Med, Div Pulm Crit Care & Sleep Med, Seoul, South Korea

[5] Catholic Univ Korea, Eunpyeong St Marys Hosp, Coll Med, Dept Internal Med, Seoul, South Korea

[6] Univ Ulsan, Asan Med Ctr, Div Geriatr, Coll Med, Seoul, South Korea

[7] Univ Ulsan, Asan Med Ctr, Dept Internal Med, Coll Med, Seoul, Gangwon Do, South Korea

[8] PyeongChang Hlth Ctr & Cty Hosp, Gangneung Si, Gangwon Do, South Korea

来源：

CHEST | 2024年 / 166卷 / 06期

关键词：

breathlessness; COPD assessment test; frailty; mMRC; sarcopenia; SHORT-FORM; KOREAN VERSION; DISEASE; IMPACT; SCALE;

D O I：

10.1016/j.chest.2024.07.180

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

BACKGROUND: Breathlessness shares aging mechanisms with frailty and sarcopenia. RESEARCH QUESTION: Are frailty and sarcopenia associated with breathlessness itself? STUDY DESIGN AND METHODS: We analyzed data from a population-based, prospective cohort study of 780 community-dwelling older adults. Breathlessness was defined using the modified Medical Research Council dyspnea scale (>= 2 points) and the COPD Assessment Test (>= 10 points). Frailty was defined by frailty index (FI); frailty phenotype; and fatigue, resistance, ambulation, illness, and weight loss (FRAIL) questionnaire results. Sarcopenia was defined by the Asian Working Group for Sarcopenia in 2019. Sarcopenia phenotype score quantified the number of criteria met. The associations of frailty and sarcopenia with breathlessness were evaluated by logistic regression analyses. Adjusted ORs (aORs) were calculated, accounting status (living alone, income, education), comorbid conditions (hypertension, diabetes, malignancy, myocardial infarction, heart failure), and other geriatric contributors (cognitive dysfunction, depression, malnutrition, polypharmacy, fall history in the past year). Institutionalization-free survival was compared by log-rank test. RESULTS: The prevalence of frailty was higher in the breathlessness group compared with the group without breathlessness (42.6% vs 10.5% by FI, 26.1% vs 8.9% by frailty phenotype, and 23.0% vs 4.2% by FRAIL questionnaire) and sarcopenia (38.3% vs 26.9%), with P < .01 for all comparisons. The multivariable logistic regression analyses showed that frailty (FI [aOR, 9.29], FRAIL questionnaire [aOR, 5.21], and frailty phenotype [aOR, 3.09]) and sarcopenia phenotype score (2 [aOR, 2.00] and 3 [aOR, 2.04] compared with 0) were associated with breathlessness. The cumulative incidence of institutionalization-free survival was higher in the breathlessness group than its counterparts (P 1/4 .02). INTERPRETATION: These findings suggest that frailty and sarcopenia strongly contribute to breathlessness in community-dwelling older adults. Measuring sarcopenia and frailty in older adults may offer opportunities to prevent age-related breathlessness.

引用

页码：1476 / 1486

页数：11

共 33 条

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