Skip to main content
SpringerLink
Log in

Daily living activities, exercise capacity, cognition, and balance in COPD patients with and without frailty

  • Original Article
  • Published:
Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Background

Information on the interaction between frailty and chronic obstructive pulmonary disease (COPD) is limited.

Aims

This study aimed to compare activities of daily living (ADL), exercise capacity, balance, and cognition in COPD patients with and without frailty.

Methods

Twenty frail and 28 non-frail COPD patients aged 55 years and over were included. Frailty was determined according to Fried et al. Dyspnea was evaluated using the modified Medical Research Council (mMRC) dyspnea scale. Respiratory and peripheral muscle strength were measured. Functional capacity was assessed using a 6-min walk test (6MWT); ADL performance was evaluated using the Glittre ADL test. The balance was evaluated using the functional reach test (FRT). Cognitive function was assessed using the Montreal Cognitive Evaluation (MoCA) Test. Quality of life was measured using the COPD Assessment Test (CAT).

Results

The mMRC and CAT scores were higher in the frail patients as compared with the non-frail patients (p < 0.05). The maximal inspiratory pressure, handgrip strength, 6MWT distance, and FRT score were lower in the frail patients as compared with the non-frail patients (p < 0.05). The duration for the Glittre ADL test was longer in the frail patients than the non-frail patients (p < 0.05). There was no significant difference between MoCA scores between groups (p > 0.05).

Conclusions

Frail COPD patients have increased dyspnea perception, impaired muscle strength, and functional capacity, ADL performance, balance, and quality of life. Whether pulmonary rehabilitation programs for patients with frail COPD need to be adapted with new rehabilitation strategies, including components of frailty, needs further investigation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Fried LP, Ferrucci L, Darer J et al (2004) Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci 59(3):255–63

    Article  Google Scholar 

  2. Fried LP, Tangen CM, Walston J et al (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56(3):M146-56

    Article  CAS  Google Scholar 

  3. Charbek E, Espiritu JR, Nayak R, Morley JE (2018) Editorial: Frailty, comorbidity, and COPD. J Nutr Health Aging 22(8):876–9

    Article  CAS  Google Scholar 

  4. Mittal N, Raj R, Islam EA, Nugent K (2016) The frequency of frailty in ambulatory patients with chronic lung diseases. J Prim Care Community Health 7(1):10–5

    Article  Google Scholar 

  5. Marengoni A, Vetrano DL, Manes-Gravina E et al (2018) The relationship between COPD and frailty: a systematic review and meta-analysis of observational studies. Chest 154(1):21–40

    Article  Google Scholar 

  6. Maddocks M, Kon SS, Canavan JL et al (2016) Physical frailty and pulmonary rehabilitation in COPD: a prospective cohort study. Thorax 71(11):988–95

    Article  Google Scholar 

  7. Park SK, Richardson CR, Holleman RG, Larson JL (2013) Frailty in people with COPD, using the National Health and Nutrition Evaluation Survey dataset (2003–2006). Heart Lung 42(3):163–70

    Article  Google Scholar 

  8. Boyd CM, Xue QL, Simpson CF et al (2005) Frailty, hospitalization, and progression of disability in a cohort of disabled older women. Am J Med 118(11):1225–31

    Article  Google Scholar 

  9. Limpawattana P, Putraveephong S, Inthasuwan P et al (2017) Frailty syndrome in ambulatory patients with COPD. Int J Chron Obstruct Pulmon Dis 12:1193–8

    Article  Google Scholar 

  10. Holland AE, Harrison SL, Brooks D (2016) Multimorbidity, frailty and chronic obstructive pulmonary disease: Are the challenges for pulmonary rehabilitation in the name? Chron Respir Dis 13(4):372–82

    Article  Google Scholar 

  11. Bandeen-Roche K, Xue Q-L, Ferrucci L et al (2006) Phenotype of frailty: characterization in the women’s health and aging studies. J Gerontol 61A(3):262–6

    Article  Google Scholar 

  12. da Silva VD, Tribess S, Meneguci J, et al (2018) Time spent in sedentary behaviour as discriminant criterion for frailty in older adults. Int J Environ Res Public Health 15(7)

  13. Miller MR, Hankinson J, Brusasco V et al (2005) Standardisation of spirometry. Eur Respir J 26(2):319–38

    Article  CAS  Google Scholar 

  14. Bestall J, Paul E, Garrod R et al (1999) Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax 54(7):581–586

    Article  CAS  Google Scholar 

  15. Divo M, Cote C, de Torres JP et al (2012) Comorbidities and risk of mortality in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 186(2):155–61

    Article  Google Scholar 

  16. Black LF, Hyatt RE (1969) Maximal respiratory pressures: normal values and relationship to age and sex. Am Rev Respir Dis 99(5):696–702

    CAS  PubMed  Google Scholar 

  17. Stark T, Walker B, Phillips JK et al (2011) Hand-held dynamometry correlation with the gold standard isokinetic dynamometry: a systematic review. PM R 3(5):472–9

    Article  Google Scholar 

  18. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories (2002) ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 166(1):111–7

  19. Yorgancioglu A, Polatli M, Aydemir O et al (2012) Reliability and validity of Turkish version of COPD assessment test. Tuberk Toraks 60(4):314–320

    Article  Google Scholar 

  20. Skumlien S, Hagelund T, Bjortuft O, Ryg MS (2006) A field test of functional status as performance of activities of daily living in COPD patients. Respir Med 100(2):316–23

    Article  Google Scholar 

  21. Duncan PW, Weiner DK, Chandler J, Studenski S (1990) Functional reach: a new clinical measure of balance. J Gerontol 45(6):M192-7

    Article  CAS  Google Scholar 

  22. Kaya Y, Aki OE, Can UA et al (2014) Validation of Montreal cognitive assessment and discriminant power of montreal cognitive assessment subtests in patients with mild cognitive impairment and Alzheimer dementia in Turkish population. J Geriatr Psychiatry Neurol 27(2):103–9

    Article  Google Scholar 

  23. Calik-Kutukcu E, Arikan H, Saglam M et al (2015) A comparison of activities of daily living in geriatric and non-geriatric patients with chronic obstructive pulmonary disease. Turk J Geriatr 18(1):68–74

    Google Scholar 

  24. Munro BH (2005) Statistical methods for health care research. Lippincott Williams & Wilkins, Philadelphia

  25. Romero-Ortuno R, Kenny RA (2012) The frailty index in Europeans: association with age and mortality. Age Ageing 41(5):684–9

    Article  Google Scholar 

  26. Ter Beek L, van derVaart H, Wempe JB et al (2020) Coexistence of malnutrition, frailty, physical frailty and disability in patients with COPD starting a pulmonary rehabilitation program Clin Nutr 39(8):2557–2563

    PubMed  Google Scholar 

  27. Kennedy CC (2017) Handgrip strength in chronic obstructive pulmonary disease: ready for prime time or frailty research tool? Ann Am Thorac Soc 14(11):1630–1

    Article  Google Scholar 

  28. Dias LS, Galvão Ferreira AC, Rodrigues da Silva Junior JL et al (2020) Prevalence of frailty and evaluation of associated variables among COPD patients. Int J Chron Obstruct Pulmon Dis 15:1349–1356

  29. Gale NS, Albarrati AM, Munnery MM et al (2018) Frailty: A global measure of the multisystem impact of COPD. Chron Respir Dis 15(4):347–55

    Article  Google Scholar 

  30. Kim TN, Choi KM (2013) Sarcopenia: definition, epidemiology, and pathophysiology. J Bone Metab 20(1):1–10

    Article  Google Scholar 

  31. Izawa KP, Watanabe S, Oka K et al (2016) Respiratory muscle strength in relation to sarcopenia in elderly cardiac patients. Aging Clin Exp Res 28(6):1143–8

    Article  Google Scholar 

  32. Ohara DG, Pegorari MS, Oliveira Dos Santos NL et al (2018) Respiratory muscle strength as a discriminator of sarcopenia in community-dwelling elderly: a cross-sectional study. J Nutr Health Aging 22(8):952–8

  33. Valenza MC, Torres-Sanchez I, Cabrera-Martos I et al (2016) Physical activity as a predictor of absence of frailty in subjects with stable COPD and COPD exacerbation. Respir Care 61(2):212–9

    Article  Google Scholar 

  34. Iwakura M, Okura K, Shibata K et al (2016) Relationship between balance and physical activity measured by an activity monitor in elderly COPD patients. Int J Chron Obstruct Pulmon Dis 11:1505–14

    Article  Google Scholar 

  35. Ierodiakonou D, Kampouraki M, Poulonirakis I et al (2019) Determinants of frailty in primary care patients with COPD: the Greek UNLOCK study. BMC Pulm Med 19(1):63

    Article  Google Scholar 

  36. Medina-Mirapeix F, Bernabeu-Mora R, Gimenez-Gimenez LM et al (2018) Physical frailty characteristics have a differential impact on symptoms as measured by the CAT score: an observational study. Health Qual Life Outcomes 16(1):140

    Article  Google Scholar 

  37. Yohannes AM, Chen W, Moga AM et al (2017) Cognitive impairment in chronic obstructive pulmonary disease and chronic heart failure: a systematic review and meta-analysis of observational studies. J Am Med Dir Assoc 18(5):451 e1–e11

  38. Tudorache E, Fildan AP, Frandes M et al (2017) Aging and extrapulmonary effects of chronic obstructive pulmonary disease. Clin Interv Aging 12:1281–7

    Article  Google Scholar 

  39. Dodd JW, Getov SV, Jones PW (2010) Cognitive function in COPD. Eur Respir J 35(4):913–22

    Article  CAS  Google Scholar 

Download references

Funding

This research was supported by Hacettepe University Scientific Research Projects Coordination Unit (grant number THD-2018-17304).

Author information

Authors and Affiliations

  1. Haseki Research and Training Hospital, Istanbul, Turkey

    Sezen Kagiali

  2. Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey

    Deniz Inal-Ince, Aslihan Cakmak, Ebru Calik-Kutukcu, Melda Saglam, Naciye Vardar-Yagli, Haluk Tekerlek & Hazal Sonbahar-Ulu

  3. Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Atilim University, Ankara, Turkey

    Hulya Arikan

  4. Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Eskisehir Osmangazi University, Eskisehir, Turkey

    Cemile Bozdemir-Ozel

  5. Faculty of Medicine, Department of Chest Diseases, Hacettepe University, Ankara, Turkey

    Lutfi Coplu

Authors
  1. Sezen Kagiali
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Deniz Inal-Ince
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Aslihan Cakmak
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ebru Calik-Kutukcu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Melda Saglam
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Naciye Vardar-Yagli
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Haluk Tekerlek
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hazal Sonbahar-Ulu
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Hulya Arikan
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Cemile Bozdemir-Ozel
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Lutfi Coplu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sezen Kagiali.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kagiali, S., Inal-Ince, D., Cakmak, A. et al. Daily living activities, exercise capacity, cognition, and balance in COPD patients with and without frailty. Ir J Med Sci 191, 817–824 (2022). https://doi.org/10.1007/s11845-021-02654-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11845-021-02654-8

Keywords

Search

Navigation