COPD In Costa Rican Elder Older Adults and Its Association with Sarcopenia

Abstract

Background: Sarcopenia is associated with to multiples comorbidities, including moreover those with some degree of inflammation. Chronic inflammatory states generate hypercatabolism and replacement of lean muscle mass for adipose tissue, decreasing muscle strength, power and function leading to disability and dependence. Here we study COPD as an important chronic inflammatory disease Strong associations have been reported between COPD and sarcopenia. The aim of this study is to evaluate the associations of COPD and sarcopenia with clinical outcomes, pulmonary function and health status and mortality. Methods: Data was taken of the CRELES- retirement cohort survey, a longitudinal study taken place in Costa Rica with a representative sample of 2820 elder adults born before 1945. Starting in 2010 with a second wave starting in 2012. The variable ‘presence of sarcopenia in patients with COPD’ was used to identify associations with independent variables (sociodemographic factors, self-rated health, comorbidities, functional status, cognitive status, pulmonary function, hospitalizations and mortality). Results: From a total of 2,827 60-year or older adults, 9.83% (n=278) were categorized as sarcopenic. A total of 18.09% referred as having a lung disease, from which 24.82% had sarcopenia (p=0.002). When grouping with sarcopenia and lung disease status, 74.24% did not had any of the conditions, 15.56% had just lung disease without sarcopenia, 7.67% had only sarcopenia without having lung disease and 2.53% had both conditions. The only group that had a higher risk of mortality was that having both conditions, with a hazard ratio of 1.81 (95% CI 1.27–2.58, p=0.001), after adjusting for age and sex. Conclusions: Older adults with lung disease have a significant higher prevalence of sarcopenia and a higher risk of mortality, than either any of the conditions alone. Special care to older adults with lung disease is important in order to detect sarcopenia and emphasize on those interventions that could impact this condition along with the regular treatment of the lung disease. This in turn could ameliorate prognosis of older adults with both conditions.