Hand grip strength as a screening tool for frailty in elderly patients with moderate to severe asthma

Asthma in the elderly is a complex disease associated with higher severity of illness, non-eosinophilic phenotype, and reduced lung function. A comprehensive approach to the underlying comorbidities and multidimensional aspects of frailty are key factors for the proper management of geriatric asthma. We carried out a cross-sectional study in a non-probabilistic sample of patients over 60 years old with a diagnosis of moderate to severe asthma according to Global Initiative for Asthma (GINA) guidelines Report 2020. We evaluated the prevalence of frailty using the Cardiovascular Health Study (CHS) Scale and hand grip strength (HGS) as an isolated predictor of frailty was accessed using the cut-offs of the European Working Group on Sarcopenia in Older People consensus (EWGSOP2). We included 78 patients with a median age of 67 years old (IQR 63-70), being composed comprising mostly of74.36% women with low socioeconomic status. Regarding asthma control, the mean Asthma Control Questionary (ACQ-5) score was 1.07 with uncontrolled disease in 26.92% of patients. The prevalence of frailty was 20.78% and the accuracy of HGS using EWGSOP2 cut-offs to predict frailty was 73.08% (sensitivity 56.25%, specificity 77.41%, positive likelihood ratio 2.49, and negative predictive value 87.27%) Although the complex interactions of asthma control in frail patients have not been fully understood, frailty may be a critical prognostic factor in patients with chronic respiratory diseases. In our study population, HGS was accurately associated with frailty by EWGSOP2 criteria. These findings suggest HGS might be a feasible surrogate marker to frailty in elderly asthmatics.