ArticleBMJ open respiratory research2023
Frailty in asthma-COPD overlap: a cross-sectional study of association and risk factors in the NHANES database.
Article in BMJ open respiratory research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
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30 citing papers in PubMed, 28 citations in OpenAlex.
- Relationship between metabolically unhealthy obesity and chronic obstructive pulmonary disease among U.S. adults: Evidence from NHANES 1999-2018.Clinics (Sao Paulo, Brazil) · 2026Article
- Interpretable machine learning framework for frailty risk prediction using NHANES 2007-2018: A cross-sectional study.Medicine · 2026Article
- Association of Frailty and Frailty Trajectory with Risk for Respiratory Infectious Diseases.Emerging infectious diseases · 2026Article
- Association between frailty and the risks of chronic pulmonary diseases and lung cancer.BMC pulmonary medicine · 2026Article
- Association of life's essential 8 with chronic respiratory disease mortality and lung health: a national cohort study.BMJ open respiratory research · 2026Article
- Exploring the association between asthma and frailty: a cross-sectional and a bidirectional Mendelian randomization study.Archives of medical science : AMS · 2026Article
- Inflammatory-metabolic alterations in asthma-COPD overlap compared with COPD: evidence from NHANES and a hospital-based cohort.Frontiers in medicine · 2026Article
- Frailty in older adults with chronic obstructive pulmonary disease: preliminary findings of prevalence and care priorities.BMC geriatrics · 2025Article
- The relationship of Systemic Inflammatory Index with asthma in adults: A retrospective cross-sectional study.The Journal of international medical research · 2025Article
- Association between multimorbidity and intrinsic capacity among older Chinese adults: evidence from the CHARLS 2011-2015.European geriatric medicine · 2025Article
- Association between preserved ratio impaired spirometry and frailty risk among US adults: a cross-sectional study.BMJ open · 2025Article
- The J-shaped relationship between body roundness index and adult asthma: insights from NHANES 2001-2018.Frontiers in nutrition · 2025Article
- Association between visceral adiposity index, lipid accumulation products, and frailty in older Americans: the 2007-2018 NHANES cross-sectional study.Frontiers in medicine · 2025Article
- Article
- Platelet-to-high-density lipoprotein ratio as a biomarker for asthma risk in adolescents: insights from NHANES 2011-2023.Frontiers in allergy · 2025Article
- The cross-sectional association between cardiometabolic index and abdominal aortic calcification in U.S. adults: evidence from NHANES 2013-2014.Frontiers in nutrition · 2025Article
- Nutritional self-management in chronic diseases: a conceptual analysis.Frontiers in public health · 2025Review
- The Red Cell Distribution Width-to-Albumin Ratio Predicts 1-Year Mortality in Patients with Chronic Obstructive Pulmonary Disease: Evidence From MIMIC-IV and NHANES.International journal of chronic obstructive pulmonary disease · 2025Article
- Prevalence and Prognostic Significance of Systemic Inflammation Index and Diet Quality in Patients with Chronic Obstructive Pulmonary Disease: Evidence from the Cohort Study of NHANES 2007-2018.International journal of chronic obstructive pulmonary disease · 2025Article
- Association between frailty and postherpetic neuralgia in the older adult with herpes zoster.Frontiers in public health · 2025Article
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Authors and funding
5 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundAsthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) is a condition characterised by the simultaneous presence of features of both asthma and COPD. The study aims to investigate the association between ACO and frailty among middle-aged and elderly populations, and identify the risk factors for frailty in individuals with ACO.
methodsWe conducted a cross-sectional study with 34 403 eligible participants (aged ≥40 years) from the National Health and Nutrition Examination Survey 1999-2018 cycles. Participants were stratified into four groups: ACO, asthma, COPD and non-asthma/COPD. Frailty assessment was based on frailty index, generating frail and non-frail group. Univariate and multivariate survey-weighted logistic regression analysis were used to determine the association between ACO and frailty, and to identify the risk factors for frailty in ACO.
resultsThe frailty prevalence in participants with ACO was 60.2%, significantly higher than that in those with asthma (32.3%) and COPD (40.6%). In the unadjusted model, participants with ACO exhibited six-fold higher odds of frailty (OR 6.30, 95% CI 5.29 to 7.49), which was significantly greater than those with COPD (OR 2.84, 95% CI 2.46 to 3.28) and asthma (OR 1.99, 95% CI 1.80 to 2.18), using the non-asthma/COPD group as a reference. After adjusting for all confounders, participants with ACO had over four times higher odds of frailty (OR 4.48, 95% CI 3.53 to 5.71), still higher than those with asthma and COPD. The findings remained robust in sensitivity and subgroup analyses. Furthermore, hypertension, cancer, cardiovascular disease, chronic kidney disease and cognitive disorders were identified as risk factors for frailty among ACO participants, while higher income and education levels were protective factors.
conclusionPatients (aged ≥40 years) with ACO were at a higher risk of frailty, regardless of age or sex, compared with those with asthma or COPD alone. Greater attention should be paid to patients with ACO, regardless of their age.
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