High Prevalence of Frailty in Patients with Adrenal Adenomas and Adrenocortical Hormone Excess - a cross-sectional multi-centre study with prospective enrolment
Abstract
OBJECTIVE
Frailty, characterized by multisystem decline, increases vulnerability to adverse health outcomes and can be measured using Frailty Index (FI). We aimed to assess the prevalence of frailty in patients with adrenal disorders (based on hormonal subtype) and examine association between FI and performance-based measures of physical function.
DESIGN
Multicenter, cross-sectional study (03/2019-08/2022).
METHODS
Adult patients with adrenal disorders (nonfunctioning adrenal adenomas [NFA], mild autonomous cortisol secretion [MACS], Cushing syndrome [CS], primary aldosteronism [PA]) and referent subjects without adrenal disorders completed a questionnaire encompassing 47 health variables (comorbidities, symptoms, daily living activities). FI was calculated as the average score of all variables and frailty defined as FI > 0.25. Physical function was assessed with hand grip, timed up-and-go test, chair rising test, 6-minute walk test, and gait speed.
RESULTS
Compared to referent subjects (n=89), patients with adrenal disorders (n=520) showed increased age, sex, and BMI-adjusted prevalence of frailty (CS [OR 19.2, 95% CI 6.7-70], MACS [OR 12.5, 95% CI 4.8-42.9], PA [OR 8.4, 95% CI 2.9-30.4], NFA [OR 4.5, 95% CI 1.7-15.9]). Prevalence of frailty was similar to referent subjects when post-dexamethasone cortisol was <28 nmol/L and was higher when post-dexamethasone cortisol was 28-50 nmol/L (OR 4.6, 95% CI 1.7-16.5). FI correlated with all measures of physical function (p<0.001).…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 520 participants or records.
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