Prevalence of frailty in patients with non-cirrhotic non-alcoholic fatty liver disease
Objective End-stage chronic liver disease is associated with accelerated ageing and increased frailty. Frailty measures have provided clinical utility in identifying patients at increased risk of poor health outcomes, including those awaiting liver transplantation. However, there is limited data on...
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BMJ Publishing Group
2022-10-01
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| Series: | BMJ Open Gastroenterology |
| Online Access: | https://bmjopengastro.bmj.com/content/9/1/e000861.full |
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| author | Damien Ferguson Suzanne Norris Marie McGrath Philip O'Gorman Sara Naimimohasses Emma McCormick Ann Monaghan Mark W Robinson John Gormley |
| author_facet | Damien Ferguson Suzanne Norris Marie McGrath Philip O'Gorman Sara Naimimohasses Emma McCormick Ann Monaghan Mark W Robinson John Gormley |
| author_sort | Damien Ferguson |
| collection | DOAJ |
| description | Objective End-stage chronic liver disease is associated with accelerated ageing and increased frailty. Frailty measures have provided clinical utility in identifying patients at increased risk of poor health outcomes, including those awaiting liver transplantation. However, there is limited data on the prevalence and severity of frailty in patients with non-cirrhotic non-alcoholic fatty liver disease (NAFLD). The aim of this study was to evaluate the prevalence of frailty and prefrailty in patients with non-cirrhotic NAFLD and correlate with severity of liver disease.Design A cross-sectional analysis of functional and laboratory frailty assessments, including the Fried frailty index (FFI), a self-reported frailty index (SRFI) and a lab-based frailty index (FI-LAB), was performed in a cohort of 109 patients with NAFLD, and results compared with fibrosis staging based on transient elastography.Results Patients with NAFLD had a high prevalence of prefrailty and frailty, with a median SRFI score of 0.18 (IQR: 0.18), FFI of 1 (IQR: 1) and FI-LAB of 0.18 (IQR: 0.12). Using the SRFI, 45% of F0/F1 patients were classified as prefrail and 20% were classified as frail, while in F2/F3 patients this increased to 36% and 41%, respectively. SRFI, 30 s sit-to-stand and FI-LAB scores increased with increasing liver fibrosis stages (p=0.001, 0.006 and <0.001, respectively). On multivariate linear regression, female gender was identified as a significant predictor of elevated frailty scores.Conclusion This study identifies a high prevalence of frailty in individuals with non-cirrhotic NAFLD. Addressing frailty through early rehabilitation interventions may reduce overall morbidity and mortality in this population. |
| format | Article |
| id | doaj-art-790e5efe6474461ea38ca3cd84a0a830 |
| institution | DOAJ |
| issn | 2054-4774 |
| language | English |
| publishDate | 2022-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Gastroenterology |
| spelling | doaj-art-790e5efe6474461ea38ca3cd84a0a8302025-08-20T03:20:54ZengBMJ Publishing GroupBMJ Open Gastroenterology2054-47742022-10-019110.1136/bmjgast-2021-000861Prevalence of frailty in patients with non-cirrhotic non-alcoholic fatty liver diseaseDamien Ferguson0Suzanne Norris1Marie McGrath2Philip O'Gorman3Sara Naimimohasses4Emma McCormick5Ann Monaghan6Mark W Robinson7John Gormley8Academic Department of Neurology, Trinity College Dublin School of Medicine, Dublin, IrelandDepartment of Hepatology, St James`s Hospital, Dublin, Ireland3 Emergency Nutrition Network, Oxford, UKDepartment of Physiotherapy, Trinity College Dublin School of Medicine, Dublin, IrelandDepartment of Hepatology, St James`s Hospital, Dublin, IrelandGastroenterology, Midlands Regional Hospital Tullamore, Tullamore, IrelandDepartment of Physiotherapy, Trinity College Dublin School of Medicine, Dublin, IrelandDepartment of Biology, Kathleen Lonsdale Institute for Human Health Research, National University of Ireland Maynooth, Maynooth, IrelandDepartment of Physiotherapy, Trinity College Dublin School of Medicine, Dublin, IrelandObjective End-stage chronic liver disease is associated with accelerated ageing and increased frailty. Frailty measures have provided clinical utility in identifying patients at increased risk of poor health outcomes, including those awaiting liver transplantation. However, there is limited data on the prevalence and severity of frailty in patients with non-cirrhotic non-alcoholic fatty liver disease (NAFLD). The aim of this study was to evaluate the prevalence of frailty and prefrailty in patients with non-cirrhotic NAFLD and correlate with severity of liver disease.Design A cross-sectional analysis of functional and laboratory frailty assessments, including the Fried frailty index (FFI), a self-reported frailty index (SRFI) and a lab-based frailty index (FI-LAB), was performed in a cohort of 109 patients with NAFLD, and results compared with fibrosis staging based on transient elastography.Results Patients with NAFLD had a high prevalence of prefrailty and frailty, with a median SRFI score of 0.18 (IQR: 0.18), FFI of 1 (IQR: 1) and FI-LAB of 0.18 (IQR: 0.12). Using the SRFI, 45% of F0/F1 patients were classified as prefrail and 20% were classified as frail, while in F2/F3 patients this increased to 36% and 41%, respectively. SRFI, 30 s sit-to-stand and FI-LAB scores increased with increasing liver fibrosis stages (p=0.001, 0.006 and <0.001, respectively). On multivariate linear regression, female gender was identified as a significant predictor of elevated frailty scores.Conclusion This study identifies a high prevalence of frailty in individuals with non-cirrhotic NAFLD. Addressing frailty through early rehabilitation interventions may reduce overall morbidity and mortality in this population.https://bmjopengastro.bmj.com/content/9/1/e000861.full |
| spellingShingle | Damien Ferguson Suzanne Norris Marie McGrath Philip O'Gorman Sara Naimimohasses Emma McCormick Ann Monaghan Mark W Robinson John Gormley Prevalence of frailty in patients with non-cirrhotic non-alcoholic fatty liver disease BMJ Open Gastroenterology |
| title | Prevalence of frailty in patients with non-cirrhotic non-alcoholic fatty liver disease |
| title_full | Prevalence of frailty in patients with non-cirrhotic non-alcoholic fatty liver disease |
| title_fullStr | Prevalence of frailty in patients with non-cirrhotic non-alcoholic fatty liver disease |
| title_full_unstemmed | Prevalence of frailty in patients with non-cirrhotic non-alcoholic fatty liver disease |
| title_short | Prevalence of frailty in patients with non-cirrhotic non-alcoholic fatty liver disease |
| title_sort | prevalence of frailty in patients with non cirrhotic non alcoholic fatty liver disease |
| url | https://bmjopengastro.bmj.com/content/9/1/e000861.full |
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