ArticleAnnals of the American Thoracic Society2017
Refining Low Physical Activity Measurement Improves Frailty Assessment in Advanced Lung Disease and Survivors of Critical Illness.
Article in Annals of the American Thoracic Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.
- Prevalence and clinical impact of frailty in COPD: a systematic review and meta-analysis.BMC pulmonary medicine · 2023Pooled it
- Frailty and Clinical Outcomes in Chronic Obstructive Pulmonary Disease.Annals of the American Thoracic Society · 2019Trial
- Inflammation, Endothelial Dysfunction, and Frailty Over 3 Years in Survivors of COVID-19 ARDS vs Pneumonia.CHEST critical care · 2026Article
- Post-Acute Sequelae of COVID-19 Persist Over 3 Years in Acute Lung Injury/Acute Respiratory Distress Syndrome Survivors But Are Not Associated With Persistent Thromboinflammation or Endothelial Dysfunction.Critical care explorations · 2026Article
- Imaging, Pulmonary Function, and Histopathologic Findings of Persistent Fibrosis in a Longitudinal Cohort 3 Years after COVID-19.Annals of the American Thoracic Society · 2025Article
- Frailty in lung transplant recipients is associated with anemia and telomere dysfunction but independent of epigenetic age.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2025Article
- Duke activity status index is not predictive of outcomes after kidney transplantation: a retrospective observational study.BMC nephrology · 2025Observational
- Rehabilitation for Physical Frailty in Lung Transplant Candidates: A Systematic Review.Cardiopulmonary physical therapy journal · 2025Article
- Relationships Between Nutrition Risk and Frailty in Candidates for Lung Transplant.Clinical transplantation · 2025Article
- Poor functional status at the time of waitlist for pediatric lung transplant is associated with worse pretransplant outcomes.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2023Article
- Development of the Lung Transplant Frailty Scale (LT-FS).The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2023Article
- Subphenotypes of frailty in lung transplant candidates.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2023Article
- Frailty and solid-organ transplant candidates: a scoping review.BMC geriatrics · 2022Article
- The Intersection of Aging and Lung Transplantation: its Impact on Transplant Evaluation, Outcomes, and Clinical Care.Current transplantation reports · 2022Article
- Feasibility of Virtual Assessment of Physical Frailty in Solid Organ Transplant Recipients: A Single Center, Observational Study.International journal of telerehabilitation · 2022Article
- Consensus document for the selection of lung transplant candidates: An update from the International Society for Heart and Lung Transplantation.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2021Article
- Frailty in Lung Transplantation: Candidate Assessment and Optimization.Transplantation · 2021Article
- Construct and Predictive Validity of Sarcopenia in Lung Transplant Candidates.Annals of the American Thoracic Society · 2021Article
- Frailty and aging-associated syndromes in lung transplant candidates and recipients.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2021Review
- Frailty subtypes and recovery in older survivors of acute respiratory failure: a pilot study.Thorax · 2021Article
Corrections and comments
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Authors and funding
24 authors at 4 institutions in 2 countries.
Funding
Abstract
rationaleThe frail phenotype has gained popularity as a clinically relevant measure in adults with advanced lung disease and in critical illness survivors. Because respiratory disease and chronic illness can greatly limit physical activity, the measurement of participation in traditional leisure time activities as a frailty component may lead to substantial misclassification of frailty in pulmonary and critical care patients.
objectivesTo test and validate substituting the Duke Activity Status Index (DASI), a simple 12-item questionnaire, for the Minnesota Leisure Time Physical Activity (MLTA) questionnaire, a detailed questionnaire covering 18 leisure time activities, as the measure of low activity in the Fried frailty phenotype (FFP) instrument.
methodsIn separate multicenter prospective cohort studies of adults with advanced lung disease who were candidates for lung transplant and older survivors of acute respiratory failure, we assessed the FFP using either the MLTA or the DASI. For both the DASI and MLTA, we evaluated content validity by testing floor effects and construct validity through comparisons with conceptually related factors. We tested the predictive validity of substituting the DASI for the MLTA in the FFP assessment using Cox models to estimate associations between the FFP and delisting/death before transplant in those with advanced lung disease and 6-month mortality in older intensive care unit (ICU) survivors.
resultsAmong 618 adults with advanced lung disease and 130 older ICU survivors, the MLTA had a substantially greater floor effect than the DASI (42% vs. 1%, and 49% vs. 12%, respectively). The DASI correlated more strongly with strength and function measures than did the MLTA in both cohorts. In models adjusting for age, sex, comorbidities, and illness severity, substitution of the DASI for the MLTA led to stronger associations of the FFP with delisting/death in lung transplant candidates (FFP-MLTA hazard ratio [HR], 1.42; 95% confidence interval [CI], 0.55-3.65; FFP-DASI HR, 2.99; 95% CI, 1.03-8.65) and with mortality in older ICU survivors (FFP-MLTA HR, 2.68; 95% CI, 0.62-11.6; FFP-DASI HR, 5.71; 95% CI, 1.34-24.3).
conclusionsThe DASI improves the construct and predictive validity of frailty assessment in adults with advanced lung disease or recent critical illness. This simple questionnaire should replace the more complex MLTA in assessing the frailty phenotype in these populations.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.