Cystic Fibrosis in Adults: A Paradigm of Frailty Syndrome? An Observational Study

Author:

Iacotucci Paola1ORCID,Carnovale Vincenzo2ORCID,Ferrillo Lorenza2,Somma Jolanda2,Bocchino Marialuisa1,D’Ippolito Marcella2,Sanduzzi Zamparelli Alessandro1ORCID,Rengo Giuseppe2ORCID,Ferrara Nicola2ORCID,Conti Valeria3ORCID,Corbi Graziamaria2ORCID

Affiliation:

1. Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80138 Naples, Italy

2. Department of Translational Medical Sciences, University of Naples “Federico II”, 80138 Naples, Italy

3. Department of Medicine Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Baronissi, 84084 Salerno, Italy

Abstract

This study aimed to assess the main clinical and anamnestic characteristics of adult Cystic Fibrosis (CF) patients and to evaluate the association of frailty with the CF genotyping classification. In an observational cross-sectional study, all ambulatory CF patients over 18 years old who received a diagnosis at the Regional Cystic Fibrosis Center for adults were enrolled and assessed by spirometry for respiratory function, by ADL and IADL for functional status, and by the Study of Osteoporotic Fractures (SOF) Index for frailty. The study population consisted of 139 CF patients (mean age 32.89 ± 10.94 years old, 46% women). Most of the subjects were robust (60.4%). The pre-frail/frail group was more frequently females (p = 0.020), had a lower BMI (p = 0.001), worse respiratory function, a higher number of pulmonary exacerbations/years, cycles of antibiotic therapy, and hospitalization (all p < 0.001) with respect to robust patients. The pre-frail/frail subjects used more drugs and were affected by more CF-related diseases (all p < 0.001). In relation to logistic regression, the best predictor of the pre-frail/frail status was a low FEV1 level. The CF patients show similarities to older pre-frail/frail subjects, suggesting that CF might be considered an early expression of this geriatric syndrome. This finding could help to better define the possible progression of CF, but overall, it could also suggest the usefulness employing of some tools used in the management and therapy of frailty subjects to identify the more severe CF subjects.

Funder

Next Generation EU

Publisher

MDPI AG

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