Longitudinal study of Chronic Obstructive Pulmonary Disease and Frailty

The demographic change is a great challenge for social welfare systems. Healthy aging is threatened by prevalent syndromes in the elderly including Chronic Obstructive Pulmonary Disease (COPD) and frailty. Both are associated with substantial morbidity, disability and mortality, though their interrelationship is insufficiently investigated. COPD is characterized by persistent airflow limitation and chronic inflammation of the airways and lungs. Frailty is the inability to compensate function loss. In this interuniversity and multidisciplinary project, we will elucidate the incidence of frailty in the Rotterdam Study, a large prospective population-based cohort study of 15.000 participants with more than 25 years follow-up, including 2.000 subjects with COPD. Secondly, we will unravel the underlying pathophysiology of the onset of frailty, including the role of exacerbations, inflammation, and sarcopenia. Thanks to a better understanding of incident frailty in subjects with and without COPD, we will be able to identify new targets to prevent and treat two devastating syndromes in the elderly. Finally, we will develop a prognostic index for vulnerable elderly in the community and validate it within the BELFRAIL elderly cohort. By providing more objectively estimated probabilities, individuals are better informed regarding their prognosis and health care professionals are aided in their reasoning and decision making regarding further management including withholding treatments.