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Asthma
Asthma is associated with frailty among community-dwelling adults: the GAZEL cohort
  1. Benjamin Landré1,
  2. Rachel Nadif2,
  3. Marcel Goldberg3,4,
  4. Julie Gourmelen3,
  5. Marie Zins3,4,
  6. Joël Ankri1,5 and
  7. Marie Herr1,5
  1. 1Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Echappement aux anti-infectieux et pharmaco-épidémiologie, CESP, 94807, Villejuif, France
  2. 2Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d’Épidémiologie Respiratoire Intégrative, CESP, 94807, Villejuif, France
  3. 3UMS 011: Population-based Epidemiological Cohorts, INSERM, Paris, France
  4. 4Faculty of Medicine, Université Paris Descartes, Paris, France
  5. 5Département Hospitalier d’Epidémiologie et de Santé Publique, Groupe Hospitalier AP-HP, Université Paris Saclay, Assistance Publique Hopitaux de Paris, Paris, France
  1. Correspondence to Dr Rachel Nadif; rachel.nadif{at}inserm.fr

Abstract

Introduction Early management of chronic respiratory diseases (CRDs) and frailty have been identified as key targets towards healthy ageing, but the association between CRDs and frailty has been poorly investigated. We studied the association between asthma and frailty in adults of the GAZEL cohort using different definitions of asthma over the 26 years of follow-up.

Methods Current asthma definitions are based on yearly self-reports of symptoms or medication (in 2015, constant reports or at least one report between 1990 and 2015), or on a detailed respiratory symptoms questionnaire in 2002. Frailty definition is based on weakness, fatigue, unintentional weight loss, low physical activity and mobility in 2015. Frail participants had three criteria or more, pre-frail 1 or 2, and robust 0. Multinomial regression models adjusted for age, sex, body mass index, smoking, education, marital status and comorbidities were performed.

Results In 2015, 12 345 adults (73% men, 61 to 77 years old) were included: 3% of them reported current asthma, 1.6% had constant reports during the follow-up and 9% reported current asthma at least once. In 2015, 6% were frail, 34% pre-frail and 13% of current asthmatics and 6% of non-asthmatics were frail (adjusted OR (aOR) 2.19 (1.44 to 3.34)). Significant associations were also found with the 2002 definition (aOR 2.24 (1.73 to 2.90)), constant reports (aOR 3.67 (1.70 to 7.93)) or at least once (aOR 1.50 (1.15 to 1.98)). Current asthma was also associated with pre-frailty with the 2002 definition (aOR 1.46 (1.26 to 1.68)).

Discussion Participants with asthma had increased risk of frailty. A better understanding of their relationship could help to define and evaluate strategies for a better ageing of asthmatics.

  • asthma epidemiology
  • asthma
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjresp-2019-000526

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    Footnotes

    • Contributors BL and RN are guarantors of the manuscript. BL and RN contributed to the study conception/design, data acquisition/analysis/interpretation, writing/revision of the manuscript and final approval of the manuscript. JG, MG, MZ, JA and MH contributed to study design, data acquisition/analysis, manuscript revision and final approval of the manuscript. The authors express their thanks to EDF-GDF, especially to the Service Général de Médecine de Contrôle, and to the ‘Caisse centrale d’action sociale du personnel des industries électrique et gazière’. The GAZEL Cohort Study was funded by EDF-GDF and INSERM, and received grants from the ‘Cohortes Santé TGIR Program’, Agence nationale de la recherché (ANR; ANR-08-BLAN-0028) and Agence française de sécurité sanitaire de l’environnement et du travail (AFSSET; EST-2008/1/35).

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Ethics approval Ethical approval was obtained from the relevant institutional review board committees. The GAZEL study was approved by the national commission overseeing data collection, storage and use in France (Commission nationale de l’informatique et des libertés (#88/25 (11/08/88)).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement No data are available.