Frailty and its association with sarcopenia and airflow limitation in Indian patients with Chronic Obstructive Pulmonary Disease: An observational cross-sectional study. (Preprint)

BACKGROUND With an estimated 50 million cases, chronic obstructive pulmonary disease (COPD) has a high prevalence in India with household smoke exposure and ambient air pollution being major risk factors rather than smoking. Skeletal muscle dysfunction presenting as sarcopenia and frailty are important but an under-researched systemic manifestation of COPD. Also unknown is the association between airflow limitation in COPD (GOLD Grade), frailty, and sarcopenia. OBJECTIVE To study the prevalence of frailty and its association with sarcopenia and airflow limitation in Indian patients with COPD. METHODS A cross-sectional study will be conducted on 65 stable patients of COPD (defined as per GOLD 2025) attending as outpatients to the Department of Respiratory Medicine. All the participants will undergo a spirometry assessment followed by evaluation for frailty using Fried's frailty phenotype assessment tool. Sarcopenia will be assessed by measuring handgrip strength, quantification of skeletal muscle mass using Lee's anthropometric prediction equation, and physical performance by gait speed test. The prevalence of frailty will be estimated with 95% confidence intervals, and its association with the severity of airflow limitation (GOLD stages) and sarcopenia will be analyzed using Chi-square tests and multivariable logistic regression, adjusting for age, sex, smoking, and body mass index. RESULTS Outcomes of the study are expected by end 2025. CONCLUSIONS The result of this study is expected to provide an objective basis to recommend frailty screening & sarcopenia assessment as a part of the out-patient evaluation of COPD patients especially those with moderate and severe airflow limitation. CLINICALTRIAL Applied for registration with The Clinical Trials Registry – India (CTRI).