Physical Activity as a Predictor of Absence of Frailty in Subjects With Stable COPD and COPD Exacerbation

BACKGROUND

Frailty is a key issue in the care of elderly patients. Patients with COPD are more likely to be frail, with a prevalence of 57.8%. Frailty is associated with a low level of physical activity. The aim of this study was to analyze the predictive power and identify the cutoffs of physical activity in their different domains (household, leisure time, and sport) for the absence of frailty in subjects with COPD exacerbation and stable COPD.

METHODS

A cross-sectional study was conducted. The participants underwent an individual interview, including sociodemographic and clinical aspects. The total physical activity and its domains were assessed by the modified Baecke questionnaire, and frailty was measured according to the modified version of Fried. A total of 212 subjects with COPD (104 stable and 108 with COPD exacerbation) were enrolled, along with 100 healthy subjects.

RESULTS

The prevalence of frailty was higher in subjects with COPD compared with the control group. An activity level of 3.54 for COPD exacerbation, 3.88 for stable COPD, and 3.50 for healthy subjects assessed using the Baecke questionnaire were recommended as the cutoff points for frailty. Sensitivity and specificity values were 0.95 and 0.807; 0.95 and 0.815; and 0.95 and 0.947, respectively.

CONCLUSIONS

Physical activity level can predict the absence or presence of frailty in subjects with stable and exacerbated COPD.

Prevalence of risk factors for atrial fibrillation and stroke among 1210 patients with sleep disordered breathing

AIMS

This study sought to identify the prevalence of risk factors for atrial fibrillation and stroke in a sleep apnea population.

METHODS

Study participants included 1210 consecutive adults who were referred with suspicion of sleep apnea. Statistical analysis was used to determine the relationship between sleep apnea syndrome and risk factors for atrial fibrillation and stroke.

RESULTS

Among 1210 enrolled patients, 65.8% had severe sleep apnea (Apnea/hypopnea Index--AHI>30), 25.2% had mild to moderate sleep apnea (AHI 5 to 30), and 8.8% had no sleep apnea (AHI<5). At baseline, the mean apnea-hypopnea index in patients with sleep apnea syndrome was 35. Compared to patients with an AHI<5, those with an AHI>30 were older (47.3±11.4 vs. 52.74±12.4, p<0.001) and had a higher body mass index (BMI) (30.7±7.3 vs. 33.83±10.1, p<0.001), a higher prevalence of hypertension (38 vs. 16%, p<0.001), and a higher CHADS2 (congestive heart failure, hypertension, age, diabetes and prior stroke) score (0.59±0.8 vs. 0.28±0.64, p<0.001).

CONCLUSIONS

Patients with severe sleep apnea have a higher prevalence of risk factors for atrial fibrillation and stroke when compared with subjects without sleep apnea.