COPD and preserved ratio impaired spirometry (PRISm) have been identified as key accelerators of frailty progression in older adults in a new study. The results were presented after a longitudinal analysis of 5,901 participants from the English Longitudinal Study of Ageing, offering significant insights for healthcare providers managing aging populations.
The research categorized lung function into three patterns: normal spirometry (NS), PRISm findings, and COPD. Frailty was tracked using the frailty index (FI), a comprehensive measure assessing vulnerability to adverse health outcomes. Over a median follow-up of 9.5 years, patients with PRISm findings and COPD experienced significantly faster FI progression compared to those with normal lung function.
PRISm findings, a newer phenotype characterized by impaired lung function despite preserved FEV1/FVC ratios, showed the most marked impact. Participants with PRISm findings exhibited an additional annual FI increase of 0.301 (95% CI, 0.211-0.392; P < .001), compared to 0.172 (95% CI, 0.102-0.242; P < .001) for those with COPD. These numbers underscore the considerable risk of frailty in patients with PRISm, a condition often underdiagnosed in clinical practice. Notably, transitions in lung function were also significant. Individuals moving from normal spirometry to PRISm findings showed accelerated FI progression (β = 0.242; 95% CI, 0.008-0.476; P = .042), while those transitioning from PRISm to normal spirometry did not experience similar declines. The study calls for further investigation into the causal mechanisms linking lung function impairments to frailty, as well as potential interventions to slow frailty progression in vulnerable patients. For healthcare professionals, this research highlights the importance of early detection and targeted management of PRISm and COPD to mitigate their impact on aging populations. Understanding the trajectory of these lung impairments is crucial to optimizing care and improving quality of life for at-risk individuals. Reference: He D et al. Preserved Ratio Impaired Spirometry and COPD Accelerate Frailty Progression. CHEST. 2024;165(3):573-82. Anaya Malik | AMJ
