Prevalence and Impact of Social Frailty in Patients with Chronic Obstructive Pulmonary Disease

Figures & data

Table 1 Characteristics of Study Participants According to the Social Frailty Group/Level

	Total	Social Robustness (n=122)	Social Prefrailty (n=134)	Social Frailty (n=149)	P value
Age	74.3±8.0	72.8±7.1	74.1±8.6	75.6±8.1	0.01
Sex (Male)	359(88.6%)	106(86.9%)	117(87.3%)	136(91.3%)	0.44
Pack-year	50.0±28.4	45.4±25.3	51.4±24.8	52.5±33.3	0.12
CAT	14.1±7.8	11.5±7.1	13.5±7.6	16.7±7.8	<0.01
mMRC	1.4±1.0	1.1±1.0	1.3±1.0	1.8±1.0	<0.01
SNAQ	14.5±1.7	15.0±1.6	14.6±1.6	13.9±1.8	<0.01
HADS-Anxiety	4.9±3.5	4.2±3.2	4.8±3.7	5.5±3.6	0.01
HADS-Depression	6.1±3.5	4.6±3.1	6.1±3.7	7.3±3.3	<0.01
BMI	22.8±4.0	22.9±3.7	23.0±3.9	22.5±4.4	0.59
%FEV1	65.1±22.4	68.6±22.2	67.6±20.4	59.7±23.5	<0.01
Getting up from a chair	265(71.6%)	81.10%	72.10%	63.50%	<0.01
Moderate exacerbation	0.47±0.93	0.31±0.64	0.52±0.94	0.55±1.1	0.07
Severe exacerbation	0.16±0.49	0.06±0.23	0.15±0.42	0.26±0.65	<0.01
Unexpected hospitalization	0.22±0.62	0.10±0.34	0.17±0.45	0.37±0.87	<0.01

Abbreviations: CAT, COPD assessment test; SNAQ, Simplified Nutritional Appetite Questionnaire; mMRC, modified Medical Research Council dyspnea scale; HADS, Hospital Anxiety and Depression Scale; FEV₁, forced expiratory volume in one second.

Figure 1 Prevalence of the severity of social frailty by age group. The prevalence of social frailty or prefrailty was more than 60% in all age groups. There were no significant differences among groups (P = 0.08).

Figure 2 Relationship between social frailty score and clinical factors in patients with chronic obstructive pulmonary disease. Spearman’s rank correlation was used to test this relationship. The total score of social frailty was significantly correlated with each clinical factor (P < 0.05).

Table 2 Clinical Characteristics of Patients with Social Frailty

	Univariate Analysis			Multivariate Analysis
	Odds Ratio	95% CI	P value	Odds Ratio	95% CI	P value
Age (year)	1.03	1.01–1.06	0.01	1.02	0.98–1.05	0.34
Sex (male)	1.55	0.79–3.04	0.21	1.50	0.65–3.47	0.33
CAT	1.07	1.04–1.10	<0.01	1.01	0.97–1.06	0.57
mMRC	1.71	1.39–2.11	<0.01	1.42	1.05–1.93	0.02
SNAQ	0.74	0.65–0.84	<0.01	0.81	0.69–0.95	<0.01
HADS-Anxiety	1.08	1.02–1.14	0.01	1.03	0.96–1.11	0.42
%FEV1 (%predicted)	0.98	0.97–0.99	<0.01	1.00	0.98–1.01	0.44
Unable to get up from a chair	1.86	1.17–2.94	<0.01	1.32	0.75–2.31	0.34

Abbreviations: CI, confidence interval; CAT, COPD assessment test; SNAQ, Simplified Nutritional Appetite Questionnaire; mMRC, modified Medical Research Council dyspnea scale; HADS, Hospital Anxiety and Depression Scale; FEV₁, forced expiratory volume in one second.

Table 3 Impact of Social Frailty on Acute Exacerbation and Unexpected Hospitalization in Patients with Chronic Obstructive Pulmonary Disease

(a)
Moderate exacerbation/year
Multivariate analysis	Standard error	β, Standardized coefficient	P-value
Social frailty	0.061	0.01 (−0.11 to 0.13)	0.86
CAT	0.008	0.24 (0.10 to 0.39)	<0.01
%FEV1	0.064	−0.16 (−0.28 to −0.03)	0.01
mMRC	0.075	0.11 (−0.04 to 0.26)	0.15
Age	0.089	−0.08 (−0.20 to 0.05)	0.22
Sex (Male)	0.089	0.03 (−0.14 to 0.21)	0.73
SNAQ	0.218	0.27 (−0.16 to 0.70)	0.22
HADS-A	0.060	0.00 (−0.11 to 0.12)	0.95
Unable to get up from a chair	0.065	−0.10 (−0.23 to 0.03)	0.12
(b)
Severe exacerbation/year
Multivariate analysis	Standard error	β, Standardized coefficient	P-value
Social frailty	0.063	0.13 (0.00 to 0.25)	0.04
CAT	0.077	0.06 (−0.09 to 0.21)	0.42
%FEV1	0.066	−0.07 (−0.19 to 0.06)	0.32
mMRC	0.077	0.13 (−0.02 to 0.28)	0.09
Age	0.063	−0.01 (−0.14 to 0.11)	0.83
Sex (Male)	0.091	−0.09 (−0.27 to 0.09)	0.31
SNAQ	0.224	0.19 (−0.25 to 0.64)	0.39
HADS-A	0.062	−0.01 (−0.13 to 0.11)	0.86
Unable to get up from a chair	0.067	0.11 (−0.02–0.24)	0.10
(c)
Unexpected hospitalization/year
Multivariate analysis	Standard error	β, Standardized coefficient	P-value
Social frailty	0.039	0.10 (0.03 to 0.18)	0.01
CAT	0.048	0.02 (−0.08 to 0.11)	0.73
%FEV1	0.040	0.03 (−0.05 to 0.11)	0.51
mMRC	0.047	0.09 (−0.01 to 0.18)	0.06
Age	0.039	−0.03 (−0.10 to 0.05)	0.47
Sex (Male)	0.056	−0.09 (−0.19 to 0.02)	0.12
SNAQ	0.137	0.01 (−0.25 to 0.28)	0.92
HADS-A	0.038	0.01 (−0.07 to 0.08)	0.89
Unable to get up from a chair	0.041	0.10 (0.02 to 0.18)	0.01

Abbreviations: CAT, COPD assessment test; SNAQ, Simplified Nutritional Appetite Questionnaire; mMRC, modified Medical Research Council dyspnea scale; HADS, Hospital Anxiety and Depression Scale; FEV₁, forced expiratory volume in one second.