Frailty affects 1 in 4 patients with COPD referred for pulmonary rehabilitation, according to research published in Thorax.

Matthew Maddocks, PhD, BSc, MCSP, King’s College London, and colleagues conducted a study of 816 outpatients with COPD (mean, 70 years old) between November 2011 and January 2015. Frailty was assessed via the Fried criteria – weight loss, exhaustion, low physical activity, slowness, and weakness – before and after patients participated in pulmonary rehabilitation.

The researchers found that 209 of 816 patients (25.6%) were frail; prevalence of frailty increased with age. Patients who were frail at the onset of the study were twice as likely to not complete the program, often due to symptom exacerbation and/or hospital admission. However, frail patients who were able to complete the rehabilitation program showed consistently better responses in exercise performance, physical activity level, and health status. At the conclusion of the study, 71 of 115 (61.3%) previously frail patients no longer met the criteria for frailty.

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“Frailty is an important clinical syndrome that is consistently associated with adverse outcomes in older people,” concluded Dr Maddocks. “However, patients who are frail respond favorably to rehabilitation, and their frailty can be reversed in the short term.”


  1. Maddocks M, Kon SSC, Canavan JL, et al. Physical frailty and pulmonary rehabilitation in COPD: a prospective cohort study. Thorax. 2016; doi: 10.1136/thoraxjnl-2016-208460