A profile of frailty in a population of stable COPD outpatients using supplemental oxygen

Frailty is a syndrome with poor physiological reserve which is associated with a poorer quality of life and longer duration of hospitalisation in people with COPD. Levels of frailty in people with COPD who are supplemental oxygen users are not well known. The aim of this study was to ascertain the prevalence of frailty in this cohort. This cross-sectional study took place in a large acute teaching hospital. Five independent frailty parameters were assessed [exhaustion, weakness, shrinking (unintentional weight loss), slowness and low physical activity levels] using the Fried frailty phenotype model. Participants were considered “frail” if they had three or more frailty parameters present, “pre-frail” if they had one or two parameters present and "non-frail" if no parameters were present. Thirty-nine participants were recruited, of which 36 (17M, 19F) completed the full assessment with a mean (SD) age 72.1 (9.4) years, mean % predicted FEV1 of 47.3 (18.2) and MRCD score 3.6 (1.1). Sixteen subjects were using both long term oxygen therapy (LTOT) and ambulatory oxygen therapy (AOT) with a mean duration of 22 (16.6) months and twenty used AOT only with a mean duration of 25 (25.3) months. The prevalence of frailty was 33.3% (n=12). Almost two-thirds (61.1%, n=22) were assigned pre-frail status. Only 5.6% (n=2) were considered non-frail. Of the frailty characteristics, the exhaustion criterion was most commonly experienced (58.3%, n=21), followed by weakness (47.2%, n=17). Over 90% of this cohort were considered pre-frail or frail. Further work should identify how best to ameliorate reversible causes of frailty in this cohort through frailty-focused rehabilitation strategies.