Frailty Syndrome and Its Relationship with Chronic Obstructive Pulmonary Disease

Öz

Although Frailty Syndrome is a geriatric syndrome associated with old age, it can also occur independently of age with comorbidity, disability and dependency. It is a situation that should be addressed at all ages, especially for individuals with chronic diseases. Frailty causes a decrease in mechanical strength and energy metabolism as a result of decreased oxygen levels due to cardiac and/or lung disease; it causes negative outcomes common to Chronic Obstructive Pulmonary Disease (COPD), such as fatigue, weight loss, decreased physical activity, and muscle atrophy. As frailty known to have a psychological and social dimension apart from its physiological dimension, it inevitably has more in common aspects with COPD in this context. Although it is not yet clear whether frailty triggers COPD or COPD frailty, it is thought that their effects on each other are quite high. In this context, it is thought that the diagnosis of frailty in individuals with COPD and multidisciplinary interventions to be applied for it, alleviating existing frailty or preventing it by detecting it in the early period are very important for the management of COPD. In this context, this review is aimed to examine the relationship between COPD and Frailty Syndrome, which have common and similar aspects, to examine the assessment tools that will help in the diagnosis, and to contribute to the literature on the management of their common components.

Anahtar Kelimeler

• Frailty
• chronic obstructive pulmonary disease
• COPD
• older age

Kırılganlık Sendromu ve Kronik Obstrüktif Akciğer Hastalığı ile İlişkisi

Öz

Kırılganlık Sendromu, yaşlılıkla ilişkilendirilen bir geriatrik sendrom olmasına karşın, komorbidite, maluliyet ve bağımlılıkla birlikte yaştan bağımsız da ortaya çıkabilmektedir. Özellikle kronik hastalığa sahip bireyler açısından her yaşta ele alınması gereken bir durumdur. Kırılganlığın kardiyak ve/veya akciğer hastalıklarına bağlı oksijen seviyesinde azalmanın sonucu olarak mekanik güçte ve enerji metabolizmasında azalmaya neden olması; yorgunluk, kilo kaybı, fiziksel aktivitede azalma ve kas atrofisi gibi Kronik Obstrüktif Akciğer Hastalığı (KOAH) ile ortak olumsuz çıktılara neden olmaktadır. Fizyolojik boyutu dışında kırılganlığın ruhsal ve sosyal boyutu da olduğundan KOAH ile kırılganlığın ortak yönünün daha fazla olduğu düşünülmektedir. Kırılganlığın mı KOAH’ı, KOAH’ın mı kırılganlığı tetiklediği halen aydınlatılamamasına karşın birbirleri üzerinde etkilerinin oldukça yüksek olduğu düşünülmektedir. Bu bağlamda özellikle KOAH’lı bireylerde kırılganlığın tanılanması ve buna yönelik uygulanacak multidisipliner girişimler, kırılganlığın önlenmesi/hafifletilmesi için tanılamasının, KOAH’ın yönetimi açısından oldukça önemli olduğu düşünülmektedir. Bu bağlamda bu derlemede, ortak ve benzer yönleri olan KOAH ve Kırılganlık Sendromunun birbirleri ile ilişkisinin ve tanılanmasına yardımcı olacak değerlendirme araçlarının incelenmesi ve ortak bileşenlerinin yönetimi ile literatüre katkı sunması amaçlanmaktadır.

Anahtar Kelimeler

• Kırılganlık
• kronik obstrüktif akciğer hastalığı
• koah
• yaşlı

Kaynakça

1. Özdemirkan T, Şenlik ZB, Şimşek AÇ. Sağlıklı aktif başarılı yaşlanma. Türkiye Sağlık Okuryazarlığı Dergisi. 2020;1(1):51–7.
2. Beğer T. Kırılgan yaşlı. XXXVI Geleneksel Çubukçu Günleri Konuşması. 2006;52(3):18–22.
3. Şahin S, Cankurtaran M. Geriatrics syndromes. Ege J Med. 2010;49(3):31–7.
4. Ahmed N, Mandel R, Fain MJ. Frailty: An emerging geriatric syndrome. Am J Med. 2007;120(9):748–53.
5. Walston J, Buta B, Xue QL. Frailty screening and ınterventions: considerations for clinical practice. Clin Geriatr Med. 2018;34(1):25–38.
6. Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. Journals Gerontol- Ser A Biol Sci Med Sci. 2004;59(3):255–63.
7. Morley JE, Vellas B, Abellan van Kan G, Anker SD, Bauer JM, Bernabei R, et al. Frailty consensus: A call to action. J Am Med Dir Assoc. 2013;14(6):392–7.
8. Kapucu S, Ünver G. Kırılgan yaşlı ve hemşirelik bakımı. Osmangazi Tıp Dergisi. 2017;39(1):122–9.

9. Eyigör S, Kutsal Y. Kırılgan yaşlıya yaklaşım. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi. 2010;56(3):135–40.
10. Veronese N, Sigeirsdottir K, Eiriksdottir G, Marques EA, Chalhoub D, Phillips CL, et al. Frailty and risk of cardiovascular diseases in older persons: the age, gene/environment susceptibility-reykjavik study. Rejuvenation Res. 2017;20(6):517–24.
11. Pollack LR, Litwack-Harrison S, Cawthon PM, Ensrud K, Lane NE, Barrett-Connor E, et al. Patterns and predictors of frailty transitions in older men: the osteoporotic fractures in men study. J Am Geriatr Soc. 2017;65(11):2473–9.
12. World Health Organization (WHO) [cited 2022 Jan 20]. Available from: https://www.who.int/health-opics/noncommunicablediseases# tab=tab_1.
13. Agustí A, Vogelmeier C, Faner R. COPD 2020: Changes and challenges. Am J Physiol Lung. 2020;319: L879–83.
14. Türk Toraks Derneği. Türk Toraks Derneği’nin GOLD 2021 kronik obstrüktif akciğer hastalığı (KOAH) raporuna bakışı. 2021. Available from: https://toraks.org.tr/site/community/news/10329.
15. Global Strategy for Prevention, Diagnosis and Management of COPD (GOLD) 2021. Available from: https://goldcopd.org/2021-gold-reports/ .
16. Global Burden of Disease Collobrations, Ärnlöv J. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. 2020;396(10258):1223-49.
17. Türkiye İstatistik Kurumu (TÜİK) [cited 2022 Jan 22]. Available from: https://data.tuik.gov.tr/Bulten/Index?p=Olum-ve-Olum-Nedeni- Istatistikleri-2019-33710.
18. Lortet-Tieulent J, Soerjomataram I, López-Campos JL, Ancochea J, Coebergh JW, Soriano JB. International trends in COPD mortality, 1995– 2017. Eur Respir J. 2019;54(6):1901791.
19. Soriano JB, Ancochea J, Celli BR. The most beautiful COPD chart in the world: all together to end COPD! Eur Respir J. 2019;54(6):1902047.
20. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. Samet J, editor. PLoS Med. 2006;3(11):2011– 30.
21. Woods NF, Faan RN, LaCroix AZ, Gray SL, Aragaki A, Cochrane BB et. al. Frailty: emergence and consequences in women aged 65 and older in The Women’s Health Initiative Observational Study. J Am Geriatr Soc. 2005;53(8):1321–30.
22. Heppenstall CP, Wilkinson TJ, Hanger HC, Keeling S. Frailty: dominos or deliberation. NZ Med J. 2009;122(1299):42–52.
23. Rockwood K. What would make a definition of frailty successful? Age Ageing. 2005;34(5):432–4.
24. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: Evidence for a phenotype. Journals Gerontol - Ser A Biol Sci Med Sci. 2001;56(3):M146–57.
25. Bozkurt C, Yildirim Y, Şenuzun Aykar F. The effect of frailty level on acceptance of illness in older people with chronic obstructive pulmonary disease. Turk Geriatr Derg. 2021;24(2):244–54.
26. Chang CI, Chan DC, Kuo KN, Hsiung CA, Chen CY. Prevalence and correlates of geriatric frailty in a Northern Taiwan Community. J Formos Med Assoc. 2011;110(4): 247–57.
27. Çakmur H. Frailty among elderly adults in a rural area of Turkey. Med Sci Monit. 2015; 21:1232–42.
28. Lang PO, Michel JP, Zekry D. Frailty syndrome: a transitional state in a dynamic process. Gerontology. 2009;55(5):539–49.
29. Cherniack EP, Florez HJ, Troen BR. Emerging therapies to treat frailty syndrome in the elderly. Altern Med Rev. 2007;12(3):246–58.
30. Strandberg TE, Pitkälä KH, Tilvis RS. Frailty in older people. Eur Geriatr Med. 2011;2(6):344–55.
31. Klein BEK, Klein R, Knudtson MD, Lee KE. Frailty, morbidity and survival. Arch Gerontol Geriatr. 2005;41(2):141–9.
32. Buchner DM, Wagner EH. Preventing frail health. Clin Geriatr Med. 1992;8(1): 1–17.
33. Wang Z, Hu X, Dai Q. Is it possible to reverse frailty in patients with chronic obstructive pulmonary disease? Clinics. 2020;75:1–6.
34. Vaz Fragoso CA, Enright PL, McAvay G, Van Ness PH, Gill TM. Frailty and respiratory impairment in older persons. Am J Med. 2012;125(1):79– 86.
35. World Health Organization (WHO) [cited 2022 Jan 22]. Available from: https://www.who.int/news-room/fact-sheets/detail/chronicobstructive- pulmonary-disease-(copd).
36. Maddocks M, Kon SSC, Canavan JL, Jones SE, Nolan CM, Labey A, et al. Physical frailty and pulmonary rehabilitation in COPD: A prospective cohort study. Thorax. 2016;71(11):988–95.
37. Park SK, Richardson CR, Holleman RG, Larson JL. Frailty in people with COPD, using the National Health and Nutrition Evaluation Survey dataset (2003-2006). Heart Lung J Acute Crit Care. 2013;42(3):163–70.
38. Uchmanowicz I, Jankowska-Polanska B, Chabowski M, Uchmanowicz B, Fal AM. The influence of frailty syndrome on acceptance of illness in elderly patients with chronic obstructive pulmonary disease. Int J COPD. 2016;11(1):2401–7.
39. Marengoni A, Vetrano DL, Manes-Gravina E, Bernabei R, Onder G, Palmer K. The relationship between COPD and frailty: a systematic review and meta-analysis of observational studies. Chest. 2018;154(1):21–40.
40. Çakıcı M. Kronik obstrüktif akciğer hastalığı olan geriatrik bireylerde dispne, bakım bağımlılığı ve kırılganlık arasındaki ilişki [master’s thesis]. [Ankara]: Hacettepe Üniversitesi, 2020.
41. Mustafaoğlu BT, Gülen ST, Birtekocak F, Karul A, Karadağ F. Factors affecting frailty syndrome in elderly chronic obstructive pulmonary disease patients and its relationship with systemic inflammation. Turk Geriatr Derg. 2020;23(4):446–54.
42. Fried LP, Borhani NO, Enright P, Furberg CD, Gardin JM, Kronmal RA, et al. The Cardiovascular Health Study: design and rationale. Ann Epidemiol. 1991;1(3):263-76.
43. Guan C, Niu H. Frailty assessment in older adults with chronic obstructive respiratory diseases. Clin Interv Aging. 2018;13:1513–24.
44. Varan HD, Deniz O, Çöteli S, Doğrul RT, Kızılarslanoğlu MC, Göker B. Validity and reliability of Fried frailty phenotype in Turkish population. Turkish J Med Sci. 2021;1-16.
45. Rockwood K, Mitnitski A. Frailty in relation to the accumulation of deficits. Journals Gerontol - Ser A Biol Sci Med Sci. 2004;62(7): 722-7.
46. Rockwood K, Howlett SE, MacKnight C, Beattie BL, Bergman H, Hébert R, et al. Prevalence, attributes, and outcomes of fitness and frailty in community-dwelling older adults: Report from the Canadian Study of Health and Aging. Journals Gerontol - Ser A Biol Sci Med Sci. 2004;59(12):1310–7.
47. Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, et al. A global clinical measure of fitness and frailty in elderly people. CMAJ. 2005;173(5):489–95.
48. Morley JE, Malmstrom TK, Miller DK. A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged african americans. J Nutr Heal Aging. 2012;16(7):601–8.
49. Hymabaccus Muradi BAB. Yaşlılarda kırılganlığı ölçmeye yönelik FRAIL Ölçeğinin Türkçe geçerlik ve güvenirlik çalışması [master’s thesis]. [Ankara]: Hacettepe Üniversitesi, 2017.
50. Akın S, Fırat Özer F, Ertürk G, Göçer Ş, Mazıcıoğlu MM, Şafak ED, et al. Which Frailty Scale predicts 4-year mortality in community-dwelling Turkish elderly better: the FRAIL Scale or the Fried Frailty Index? Erciyes Med J. 2019;41(1):56-61.
51. Fukutomi E, Okumiya K, Wada T, Sakamoto R, Ishimoto Y, Kimura Y, et al. Relationships between each category of 25-item frailty risk assessment (Kihon Checklist) and newly certified older adults under Long-Term Care Insurance: A 24-month follow-up study in a rural community in Japan. Geriatr Gerontol Int. 2015;15(7):864–71.
52. Satake S, Shimokata H, Senda K, Kondo I, Toba K. Validity of total Kihon Checklist Score for predicting the ıncidence of 3-year dependency and mortality in a community-dwelling older population. J Am Med Dir Assoc. 2017;18(6):552.e1-e6.
53. Esenkaya ME, Dokuzlar O, Soysal P, Smith L, Jackson SE, Isik AT. Validity of the Kihon Checklist for evaluating frailty status in Turkish older adults. Geriatr Gerontol Int. 2019;19(7):616–21.
54. Rolfson DB, Majumdar SR, Tsuyuki RT, Tahir A, Rockwood K. Validity and reliability of the Edmonton Frail Scale. Age and Ageing. 2006;35(5):526-9.
55. Aygör HE, Fadıloğlu Ç, Şahin S, Aykar FŞ, Akçiçek F. Validation of Edmonton Frail Scale into elderly Turkish population. Arch Gerontol Geriatr. 2018;76:133–7.
56. Gobbens RJJ, van Assen MALM, Luijkx KG, Wijnen-Sponselee MT, Schols JMGA. The Tilburg Frailty Indicator: psychometric properties. J Am Med Dir Assoc. 2010;11(5):344–55.
57. Arslan M, Koç EM, Sözmen MK. The Turkish adaptation of the Tilburg Frailty Indicator: A validity and reliability study. Turk Geriatr Derg. 2018;21(2):173–83.
58. Topcu Y, Tufan F, Kilic C. Turkish version of the Tilburg Frailty Indicator. Clin Interv Aging. 2019; 14:615–20.
59. Tambağ H. Yaşlılarda sağlıklı yaşam biçimi davranışları ve yaşam doyumu. Mustafa Kemal Üniversitesi Tıp Dergisi. 2013;4(16):23-31.
60. Arslan S. Yaşlılarda KOAH ve beslenme yaklaşımları. Sağlık Akademisi Kastamonu. 2019;5(1):78-90.
61. Bozkurt C. Kronik obstrüktif akciğer hastalığı olan yaşlı bireylerde kırılganlık düzeyinin hastalığın kabulü üzerine etkisi [master’s thesis]. [İzmir]: Ege Üniversitesi, 2018.
62. Morley JE. Frailty: diagnosis and management. J Nutr Health Aging. 2011;15:667–70.
63. Gosselink, R., Troosters, T., Decramer, M., Distribution of muscle weakness in patients with stable chronic obstructive pulmonary disease. J Cardiopulm Rehabil. 2000;20(6):353-60.
64. Besen DB, Esen A. Hastalığı Kabul Ölçeğinin Türk toplumundaki diyabetik bireylere uyarlanması. Turk Silahlı Kuvvetleri Koruyucu Hekim Bul. 2011;10(2):155-64.
65. Takahashi S, Hirano T, Yasuda K, Donishi T, Suga K, Doi K, et al. Impact of frailty on hippocampal volume in patients with chronic obstructive pulmonary disease. Biomedicines. 2021;9(9):1103.