A vicious cycle of frailty and acute lower respiratory infection among community-dwelling adults (≥ 60 years): Findings from a multi-site INSPIRE cohort study, India
2024

Frailty and Acute Lower Respiratory Infection in Older Adults in India

Sample size: 5801 publication 10 minutes Evidence: high

Author Information

Author(s): Saha Siddhartha, Amarchand Ritvik, Kumar Rakesh, O. Prabhakaran Aslesh, Rajkumar Prabu, Dutt Bhardwaj Sumit, Kanungo Suman, Gharpure Radhika, Lafond Kathryn E., Azziz-Baumgartner Eduardo, Krishnan Anand

Primary Institution: Centers for Disease Control and Prevention, New Delhi, India

Hypothesis

ALRI may aggravate frailty among older adults.

Conclusion

Frailty can both increase the risk of acute lower respiratory infections and worsen after such infections in older adults.

Supporting Evidence

  • 61.5% of participants were non-frail at enrollment.
  • Vulnerable participants had a 1.6 times higher risk of ALRI compared to non-frail participants.
  • Frail participants had a 1.7 times higher risk of ALRI compared to non-frail participants.
  • Participants with ALRI were at increased risk of worsening frailty category.

Takeaway

Older people who are weak or frail are more likely to get sick with lung infections, and getting sick can make them even weaker.

Methodology

The study involved a multi-site cohort of community-dwelling older adults who were assessed for frailty and monitored for ALRI episodes over a year.

Potential Biases

Survival bias may have affected the results as participants who died were not included in subsequent assessments.

Limitations

Cultural factors may have influenced frailty assessments, and the study excluded participants who died during the study period, potentially underestimating the effects of ALRI.

Participant Demographics

Median age was 65 years, with 41% males and a significant portion having less than five years of formal education.

Statistical Information

P-Value

1.9

Confidence Interval

95% CI 1.3–2.2

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pgph.0003903

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