HomeMedical SpecialtiesPulmonary and RespirologyHow frailty can impact lung disease

How frailty can impact lung disease

Published on

A new study from UHN’s Toronto General Hospital Research Institute (TGHRI) has identified the impact of frailty on hospitalized patients with interstitial lung diseases (ILD).

Interstitial lung diseases are a group of lung disorders that cause progressive scarring and declining lung function.

Every year, between three per cent and 14 per cent of patients with ILD suffer acute exacerbations flare-ups (AE-ILD), which are associated with high morbidity and mortality. Identifying risk factors is crucial for predicting outcomes, allocating resources, assessing transplant eligibility and optimizing recovery.

“Frailty is a syndrome characterized by the reduced reserve of energy to maintain functions and cope with stressors that happens as we age,” says Dr. Dmitry Rozenberg, a scientist at TGHRI, assistant professor in the Temerty Faculty of Medicine at the University of Toronto (U of T) and senior author of the study.

“Frailty is often associated with greater risks in chronic lung diseases and has also been associated with diminished quality of life and transplant-free survival in patients with chronic respiratory diseases.”

Although it is known that frailty can be an indicator of outcome for patients with ILD and that approximately half of ILD patients experience frailty, the implications of frailty during acute exacerbations of ILD have remained largely unexplored.

“Our study aimed to understand the association between frailty and various aspects of AE-ILD, including clinical characteristics, physical function, hospital outcomes and post-AE-ILD recovery,” says Dr. Marine Van Hollebeke, former postdoctoral researcher at UHN and co-first author of the study.

Dr. Van Hollebeke was co-supervised by Dr. Rozenberg and Dr. W Darlene Reid, Senior Scientist at UHN’s KITE Research Institute, a professor at U of T, and co-author on the study.

The team analyzed retrospective data spanning from January 2015 to October 2018.

They examined 89 patients hospitalized with AE-ILD, 31 of them being identified as having frailty based on a previously developed index. This indicates that frailty is prevalent, being present in one-third of patients admitted with AE-ILD.

“We found that patients with frailty tended to be older, had a higher burden of comorbidities – for example, diabetes or cardiovascular disease, exhibited reduced physical function prior to hospitalization, and decreased independence,” says Dr. Karan Chohan, former medical student at U of T and co-first author of the study.

“Patients with frailty also had more major medical complications – 32 per cent of patients with frailty versus 10 per cent without – and required more multidisciplinary support during hospitalization.”

However, the study also showed that frailty was not associated with one-year mortality when factoring in lung transplantation, which is a life-saving procedure.

This study underscores the importance of identifying frailty in ILD patients, as it may help health care providers better understand prognosis, allocate resources more effectively, and tailor care plans to address the specific needs of individuals.

Future research will evaluate if frailty can be modified prior to or during hospitalization with AE-ILD and whether offering rehabilitation strategies during or after hospitalization can improve hospital and post-discharge outcomes.

Latest articles

The Canadian Consensus Statement on the management of venous leg ulcers

This Consensus Statement was developed with the objective of creating a concise document that...

A pathway to independence for patients with rare disease

Nearly 20 years ago, Audrey Gouskos came through the St. Michael’s Hospital Emergency Department...

Robotic-assisted rehabilitation now available in Fraser Health

Stroke patient Leanne Mork is learning to walk again with the assistance of a...

Helping Canada Design Health Care Facilities for Future Needs

Health care facilities (HCFs) play an important role in communities, providing a safe, secure,...

More like this

Move more, age well: prescribing physical activity for older adults as a recipe for healthy aging

Can physical activity extend the lifespans of older adults? A review article published in CMAJ (Canadian...

Antipsychotic use has been rising in long-term care homes, but we can do something about it – we’ve done it before

As health care providers working in long-term care (LTC), we’ve seen firsthand how antipsychotic...

Dementia and expressive behaviours capacity building through innovation and partnerships

The growing senior population in Ontario poses unique challenges to the healthcare system. By...

Canadian first: Sunnybrook achieves second level of age-friendly health system designation

Sunnybrook Health Sciences Centre is proud to announce a first-in-Canada recognition, as we received...

‘Healthy aging’: Education empowers patients when it comes to preventing falls

A pilot program at Providence Healthcare hopes to empower patients to be more active...

Personalized home evaluation tool for older adults and people with disabilities wins national competition

Canadian startup Incluzia Inc. has won the 2024 AGE-WELL National Impact Challenge: Solutions for...