Skip to main content
Top
Published in: Health and Quality of Life Outcomes 1/2018

Open Access 01-12-2018 | Research

Physical frailty characteristics have a differential impact on symptoms as measured by the CAT score: an observational study

Authors: Francesc Medina-Mirapeix, Roberto Bernabeu-Mora, Luz María Giménez-Giménez, Pilar Escolar-Reina, Mariano Gacto-Sánchez, Silvana Loana de Oliveira-Sousa

Published in: Health and Quality of Life Outcomes | Issue 1/2018

Login to get access

Abstract

Background

The physical frailty status affects the health status of patients with chronic obstructive pulmonary disease (COPD). The objective was to determine if the individual physical frailty characteristics have a differential impact on the CAT score.

Methods

This observational study included 137 patients with stable COPD. Physical frailty was measured with unintentional weight loss, low physical activity, exhaustion, slow walking speed and low grip strength and health status assessed with the COPD Assessment test (CAT). The following variables were evaluated as potential determinants of CAT: sex, age, body mass index, smoking, dyspnea, exacerbations, comorbidities, %FEV1, %FVC, anxiety and depression.

Results

The prevalence of characteristics for individual frailty was as follows: low grip strength, 60.6%; low physical activity, 27.0%; exhaustion, 19.7%; slow walking speed, 9.5%; and unintentional weight loss, 7.3%. A total of 17.5% of the patients were non-frail, 73.7% were pre-frail and only 8.7% were frail. One of the five frailty characteristics, exhaustion (adjusted β coefficient 5.12 [standard error = 1.27], p = 0.001) was an independent determinant of CAT score in the final regression model which was adjusted by other independent determinants of CAT (dyspnea, exacerbations and anxiety).

Conclusions

Due to the fact that exhaustion is a frequent and relevant psychological symptom on CAT score of patients with COPD, interventions should reduce that stress. Future research should explore how exhaustion persists or remits over time.
Literature
1.
2.
go back to reference Lee SD, Huang MS, Kang J, et al. The COPD assessment test (CAT) assists prediction of COPD exacerbations in high-risk patients. Respir Med. 2014;108(4):600–8.CrossRefPubMed Lee SD, Huang MS, Kang J, et al. The COPD assessment test (CAT) assists prediction of COPD exacerbations in high-risk patients. Respir Med. 2014;108(4):600–8.CrossRefPubMed
3.
go back to reference Oga T, Nishimura K, Tsukino M, et al. Analysis of the factors related to mortality in chronic obstructive pulmonary disease. Role of exercise capacity and health status. Am J Respir Crit Care Med. 2003;167(4):544–9.CrossRefPubMed Oga T, Nishimura K, Tsukino M, et al. Analysis of the factors related to mortality in chronic obstructive pulmonary disease. Role of exercise capacity and health status. Am J Respir Crit Care Med. 2003;167(4):544–9.CrossRefPubMed
4.
5.
go back to reference Negro RW, Bonadiman L, Turco P. Sensitivity of the COPD assessment test (CAT questionnaire) investigated in a population of 681 consecutive patients referring to a lung clinic: the first Italian specific study. Multidiscip Resp Med. 2014;9(1):15.CrossRef Negro RW, Bonadiman L, Turco P. Sensitivity of the COPD assessment test (CAT questionnaire) investigated in a population of 681 consecutive patients referring to a lung clinic: the first Italian specific study. Multidiscip Resp Med. 2014;9(1):15.CrossRef
6.
go back to reference Kelly JL, Bamsey O, Smith C, et al. Health status assessment in routine clinical practice: the chronic obstructive pulmonary disease assessment test score in outpatients. Respiration. 2012;84(3):193–9.CrossRefPubMed Kelly JL, Bamsey O, Smith C, et al. Health status assessment in routine clinical practice: the chronic obstructive pulmonary disease assessment test score in outpatients. Respiration. 2012;84(3):193–9.CrossRefPubMed
7.
go back to reference Jones PW, Harding G, Berry P, et al. Development and first validation of the COPD assessment test. Eur Respir J. 2009;34(3):648–54.CrossRefPubMed Jones PW, Harding G, Berry P, et al. Development and first validation of the COPD assessment test. Eur Respir J. 2009;34(3):648–54.CrossRefPubMed
8.
go back to reference Atis Nayci S, Ozgür ES, Ozge C, et al. Impact of comorbidities on COPD Assessment Test (CAT) scores. Chest. 2014;145(Suppl 3):431D.CrossRef Atis Nayci S, Ozgür ES, Ozge C, et al. Impact of comorbidities on COPD Assessment Test (CAT) scores. Chest. 2014;145(Suppl 3):431D.CrossRef
9.
go back to reference Maddocks M, Kon SS, Canavan JL, et al. Physical frailty and pulmonary rehabilitation in COPD: a prospective cohort study. Thorax. 2016;71(11):988–95.CrossRefPubMedPubMedCentral Maddocks M, Kon SS, Canavan JL, et al. Physical frailty and pulmonary rehabilitation in COPD: a prospective cohort study. Thorax. 2016;71(11):988–95.CrossRefPubMedPubMedCentral
10.
go back to reference Fried LP, Ferruci L, Darer J, et al. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci. 2004;59(3):255–63.CrossRefPubMed Fried LP, Ferruci L, Darer J, et al. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci. 2004;59(3):255–63.CrossRefPubMed
11.
go back to reference Park SK, Richardson CR, Holleman RG, et al. Frailty in people with COPD, using the National Health and nutrition evaluation survey dataset (2003−2006). Heart Lung. 2013;42(3):163–70.CrossRefPubMedPubMedCentral Park SK, Richardson CR, Holleman RG, et al. Frailty in people with COPD, using the National Health and nutrition evaluation survey dataset (2003−2006). Heart Lung. 2013;42(3):163–70.CrossRefPubMedPubMedCentral
12.
go back to reference UchmanowicznI J-PB, Chabowski M, et al. The influence of frailty syndrome on acceptance of illness in elderly patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2016;11:2401–7.CrossRef UchmanowicznI J-PB, Chabowski M, et al. The influence of frailty syndrome on acceptance of illness in elderly patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2016;11:2401–7.CrossRef
13.
go back to reference Lahousse L, Ziere G, Verlinden V, et al. Risk of frailty in elderly with COPD: a population-based study. J Gerontol A Biol Sci Med Sci. 2016;71(5):689–95.CrossRefPubMed Lahousse L, Ziere G, Verlinden V, et al. Risk of frailty in elderly with COPD: a population-based study. J Gerontol A Biol Sci Med Sci. 2016;71(5):689–95.CrossRefPubMed
14.
go back to reference Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56.CrossRefPubMed Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56.CrossRefPubMed
16.
17.
go back to reference García-Aymerich J, Farrero E, Félez MA, et al. Risk factors of readmission to hospital for a COPD exacerbation: a prospective study. Thorax. 2003;58(2):100–5.CrossRefPubMedPubMedCentral García-Aymerich J, Farrero E, Félez MA, et al. Risk factors of readmission to hospital for a COPD exacerbation: a prospective study. Thorax. 2003;58(2):100–5.CrossRefPubMedPubMedCentral
18.
go back to reference Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385–401.CrossRef Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385–401.CrossRef
19.
go back to reference Kon SS, Patel MS, Canavan JL, et al. Reliability and validity of 4-metre gait speed in COPD. Eur Respir J. 2013;42(2):333–40.CrossRefPubMed Kon SS, Patel MS, Canavan JL, et al. Reliability and validity of 4-metre gait speed in COPD. Eur Respir J. 2013;42(2):333–40.CrossRefPubMed
20.
go back to reference Medina-Mirapeix F, Bernabeu-Mora R, Llamazares-Herrán E, et al. Interobserver reliability of peripheral muscle strength tests and short physical performance battery in patients with chronic obstructive pulmonary disease: a prospective observational study. Arch Phys Med Rehabil. 2016;97(11):2002–5.CrossRefPubMed Medina-Mirapeix F, Bernabeu-Mora R, Llamazares-Herrán E, et al. Interobserver reliability of peripheral muscle strength tests and short physical performance battery in patients with chronic obstructive pulmonary disease: a prospective observational study. Arch Phys Med Rehabil. 2016;97(11):2002–5.CrossRefPubMed
21.
go back to reference Agustí A, Soler JJ, Molina J, et al. Is CAT questionnaire sensitive to changes in health status in patients with severe COPD exacerbations? COPD. 2012;9(5):492–8.CrossRefPubMed Agustí A, Soler JJ, Molina J, et al. Is CAT questionnaire sensitive to changes in health status in patients with severe COPD exacerbations? COPD. 2012;9(5):492–8.CrossRefPubMed
22.
go back to reference Herrero MJ, Blanch J, Peri JM, et al. A validation study of the hospital anxiety and depression scale (HADS) in a Spanish population. Gen Hosp Psychiatry. 2003;25(4):277–83.CrossRefPubMed Herrero MJ, Blanch J, Peri JM, et al. A validation study of the hospital anxiety and depression scale (HADS) in a Spanish population. Gen Hosp Psychiatry. 2003;25(4):277–83.CrossRefPubMed
23.
go back to reference Tabachnick B, Fidell L. Using multivariate statistics. 6th ed. Boston: Pearson Education; 2013. Tabachnick B, Fidell L. Using multivariate statistics. 6th ed. Boston: Pearson Education; 2013.
24.
go back to reference Demeyer H, Dueñas-Espín I, De Jongh C, et al. Can health status questionnaires be used as a measure of physical activity in COPD patients? Eur Respir J. 2016; 47(5):1565-1568. Erratum in: Eur Respir J 2017; 49(2). Demeyer H, Dueñas-Espín I, De Jongh C, et al. Can health status questionnaires be used as a measure of physical activity in COPD patients? Eur Respir J. 2016; 47(5):1565-1568. Erratum in: Eur Respir J 2017; 49(2).
25.
go back to reference Siafakas NM, Vermiere P, Pride NB. Optimal assessment and management of chronic obstructive pulmonary disease (COPD). Eur Respir J. 1995;8:1398–420.CrossRefPubMed Siafakas NM, Vermiere P, Pride NB. Optimal assessment and management of chronic obstructive pulmonary disease (COPD). Eur Respir J. 1995;8:1398–420.CrossRefPubMed
26.
go back to reference Dürr S, Zogg S, Miedinger D, et al. Daily physical activity, functional capacity and quality of life in patients with COPD. COPD 2014; 11(6):689–696. Dürr S, Zogg S, Miedinger D, et al. Daily physical activity, functional capacity and quality of life in patients with COPD. COPD 2014; 11(6):689–696.
27.
go back to reference Haas BM, Trew M, Castle PC. Effects of respiratory weakness on daily living function, quality of life, activity levels, and exercise capacity in mild to moderate Parkinson’s disease. Am J Phys Med Rehabil. 2004;83(8):601–7.CrossRefPubMed Haas BM, Trew M, Castle PC. Effects of respiratory weakness on daily living function, quality of life, activity levels, and exercise capacity in mild to moderate Parkinson’s disease. Am J Phys Med Rehabil. 2004;83(8):601–7.CrossRefPubMed
28.
go back to reference O'Donnell DE, Hernandez P, Kaplan A, et al. Canadian Thoracic Society recommendations for management of chronic obstructive pulmonary disease - 2008 update - highlights for primary care. Can Respir J. 2008;15(Suppl A):1A–8A.PubMedPubMedCentral O'Donnell DE, Hernandez P, Kaplan A, et al. Canadian Thoracic Society recommendations for management of chronic obstructive pulmonary disease - 2008 update - highlights for primary care. Can Respir J. 2008;15(Suppl A):1A–8A.PubMedPubMedCentral
29.
go back to reference Gale NS, Albarrati AM, Munnery MM, et al. Frailty: a global measure of the multisystem impact of COPD. Chron Respir Dis. 2018;1:1479972317752763. Gale NS, Albarrati AM, Munnery MM, et al. Frailty: a global measure of the multisystem impact of COPD. Chron Respir Dis. 2018;1:1479972317752763.
30.
go back to reference Whitson HE, Thielke S, Diehr P, et al. Patterns and predictors of recovery from exhaustion in older adults: the cardiovascular health study. J Am Geriatr Soc. 2011;59(2):207–13.CrossRefPubMedPubMedCentral Whitson HE, Thielke S, Diehr P, et al. Patterns and predictors of recovery from exhaustion in older adults: the cardiovascular health study. J Am Geriatr Soc. 2011;59(2):207–13.CrossRefPubMedPubMedCentral
31.
go back to reference Woo K. A pilot study to examine the relationships of dyspnea, physical activity and fatigue in patients with chronic obstructive pulmonary disease. J Clin Nurs. 2000;9(4):526–33.CrossRefPubMed Woo K. A pilot study to examine the relationships of dyspnea, physical activity and fatigue in patients with chronic obstructive pulmonary disease. J Clin Nurs. 2000;9(4):526–33.CrossRefPubMed
32.
go back to reference Kentson M, Tödt K, Skargren E, et al. Factors associated with experience of fatigue, and functional limitations due to fatigue in patients with stable COPD. Ther Adv Respir Dis. 2016;10(5):410–24.CrossRefPubMedPubMedCentral Kentson M, Tödt K, Skargren E, et al. Factors associated with experience of fatigue, and functional limitations due to fatigue in patients with stable COPD. Ther Adv Respir Dis. 2016;10(5):410–24.CrossRefPubMedPubMedCentral
33.
go back to reference Bratas O, Espnes GA, Rannestad T, et al. Characteristics of patients with chronic obstructive pulmonary disease choosing rehabilitation. J Rehabil Med. 2010;42(4):362–7.CrossRefPubMed Bratas O, Espnes GA, Rannestad T, et al. Characteristics of patients with chronic obstructive pulmonary disease choosing rehabilitation. J Rehabil Med. 2010;42(4):362–7.CrossRefPubMed
34.
go back to reference Dodd JW, Hogg L, Nolan J, et al. The COPD assessment test (CAT): response to pulmonary rehabilitation. A multicentre, prospective study. Thorax. 2011;66(5):425–9.CrossRefPubMed Dodd JW, Hogg L, Nolan J, et al. The COPD assessment test (CAT): response to pulmonary rehabilitation. A multicentre, prospective study. Thorax. 2011;66(5):425–9.CrossRefPubMed
35.
go back to reference Medina-Mirapeix F, Del Baño-Aledo ME, Oliveira-Sousa SL, et al. How the rehabilitation environment influences patient perception of service quality: a qualitative study. Arch Phys Med Rehabil. 2013;94(6):1112–7.CrossRefPubMed Medina-Mirapeix F, Del Baño-Aledo ME, Oliveira-Sousa SL, et al. How the rehabilitation environment influences patient perception of service quality: a qualitative study. Arch Phys Med Rehabil. 2013;94(6):1112–7.CrossRefPubMed
36.
go back to reference Bernabeu-Mora R, García-Guillamón G, Valera-Novella E, et al. Frailty is a predictive factor of readmission within 90 days of hospitalization for acute exacerbations of chronic obstructive pulmonary disease: a longitudinal study. Ther Adv Respir Dis. 2017:1–10. Bernabeu-Mora R, García-Guillamón G, Valera-Novella E, et al. Frailty is a predictive factor of readmission within 90 days of hospitalization for acute exacerbations of chronic obstructive pulmonary disease: a longitudinal study. Ther Adv Respir Dis. 2017:1–10.
Metadata
Title
Physical frailty characteristics have a differential impact on symptoms as measured by the CAT score: an observational study
Authors
Francesc Medina-Mirapeix
Roberto Bernabeu-Mora
Luz María Giménez-Giménez
Pilar Escolar-Reina
Mariano Gacto-Sánchez
Silvana Loana de Oliveira-Sousa
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2018
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-018-0969-9

Other articles of this Issue 1/2018

Health and Quality of Life Outcomes 1/2018 Go to the issue