High prevalence of frailty in patients with adrenal adenomas and adrenocortical hormone excess: a cross-sectional multi-centre study with prospective enrolment
Frailty, characterized by multi-system 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 sub-type) and examine association between FI and perform...
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| Veröffentlicht in: | European journal of endocrinology 2023-09, Vol.189 (3), p.318-326 |
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| creator | Dogra, Prerna Šambula, Lana Saini, Jasmine Thangamuthu, Karthik Athimulam, Shobana Delivanis, Danae A Baikousi, Dimitra A Nathani, Rohit Zhang, Catherine D Genere, Natalia Salman, Zara Turcu, Adina F Ambroziak, Urszula Garcia, Raul G Achenbach, Sara J Atkinson, Elizabeth J Singh, Sumitabh LeBrasseur, Nathan K Kastelan, Darko Bancos, Irina |
| description | Frailty, characterized by multi-system 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 sub-type) and examine association between FI and performance-based measures of physical function.
Multi-centre, cross-sectional study (March 2019-August 2022).
Adult patients with adrenal disorders (non-functioning 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.
Compared to referent subjects (n = 89), patients with adrenal disorders (n = 520) showed increased age, sex, and body mass index-adjusted prevalence of frailty (CS [odds ratio-OR 19.2, 95% confidence interval-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 |
| doi_str_mv | 10.1093/ejendo/lvad113 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2853942847</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2853942847</sourcerecordid><originalsourceid>FETCH-LOGICAL-c335t-e78f6cb2605603963509755348a45c3bf8a453ddaeab545b6c66ca120bc6a9633</originalsourceid><addsrcrecordid>eNo9kU9P3DAQxa2Kqiy0V46Vj1yyOOs_SXqrEJRKSFxA4hZNnAlr5Nip7SzdT8NXrbfZ9vRG4997GusRclGydckafoWv6Hp_ZXfQlyX_QFalqJpC1fz5hKxYzUQhlOCn5CzGV8bKPLNP5JRXsmGNEivyfmdetnQKuAOLTiP1Ax0CGJv21Dg6QTLoUqRvJm0p9AEd2Kzo_AiRguuXpdc-JKPz29aH0Tuk-FtjjN8oUB18jEVEnYw_uMfZJlPoHBuQxjT3-yV9ytx0oHbZ7YK3Y0Y-k48D2IhfjnpOnm5vHq_vivuHHz-vv98XmnOZCqzqQeluo5hUjDeKS9ZUUnJRg5Cad8NBed8DQieF7JRWSkO5YZ1WkHF-Ti6X3HzFrxljakcTNVoLDv0c200teSM2tagyul7Qvx8LOLRTMCOEfVuy9lBKu5TSHkvJhq_H7Lkbsf-P_2uB_wFeYI8S</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2853942847</pqid></control><display><type>article</type><title>High prevalence of frailty in patients with adrenal adenomas and adrenocortical hormone excess: a cross-sectional multi-centre study with prospective enrolment</title><source>MEDLINE</source><source>Oxford University Press Journals All Titles (1996-Current)</source><creator>Dogra, Prerna ; Šambula, Lana ; Saini, Jasmine ; Thangamuthu, Karthik ; Athimulam, Shobana ; Delivanis, Danae A ; Baikousi, Dimitra A ; Nathani, Rohit ; Zhang, Catherine D ; Genere, Natalia ; Salman, Zara ; Turcu, Adina F ; Ambroziak, Urszula ; Garcia, Raul G ; Achenbach, Sara J ; Atkinson, Elizabeth J ; Singh, Sumitabh ; LeBrasseur, Nathan K ; Kastelan, Darko ; Bancos, Irina</creator><creatorcontrib>Dogra, Prerna ; Šambula, Lana ; Saini, Jasmine ; Thangamuthu, Karthik ; Athimulam, Shobana ; Delivanis, Danae A ; Baikousi, Dimitra A ; Nathani, Rohit ; Zhang, Catherine D ; Genere, Natalia ; Salman, Zara ; Turcu, Adina F ; Ambroziak, Urszula ; Garcia, Raul G ; Achenbach, Sara J ; Atkinson, Elizabeth J ; Singh, Sumitabh ; LeBrasseur, Nathan K ; Kastelan, Darko ; Bancos, Irina</creatorcontrib><description>Frailty, characterized by multi-system 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 sub-type) and examine association between FI and performance-based measures of physical function.
Multi-centre, cross-sectional study (March 2019-August 2022).
Adult patients with adrenal disorders (non-functioning 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.
Compared to referent subjects (n = 89), patients with adrenal disorders (n = 520) showed increased age, sex, and body mass index-adjusted prevalence of frailty (CS [odds ratio-OR 19.2, 95% confidence interval-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 < .001).
Whilst frailty prevalence was highest in patients with adrenocortical hormone excess, even patients with NFA demonstrated an increased prevalence compared to the referent population. Future longitudinal studies are needed to evaluate the impact of various management strategies on frailty.</description><identifier>ISSN: 0804-4643</identifier><identifier>ISSN: 1479-683X</identifier><identifier>EISSN: 1479-683X</identifier><identifier>DOI: 10.1093/ejendo/lvad113</identifier><identifier>PMID: 37590964</identifier><language>eng</language><publisher>England</publisher><subject>Adenoma - epidemiology ; Adrenocortical Adenoma ; Adult ; Cross-Sectional Studies ; Cushing Syndrome ; Dexamethasone ; Frailty - epidemiology ; Hand Strength ; Humans ; Hydrocortisone ; Prevalence ; Prospective Studies</subject><ispartof>European journal of endocrinology, 2023-09, Vol.189 (3), p.318-326</ispartof><rights>The Author(s) 2023. Published by Oxford University Press on behalf of European Society of Endocrinology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c335t-e78f6cb2605603963509755348a45c3bf8a453ddaeab545b6c66ca120bc6a9633</citedby><cites>FETCH-LOGICAL-c335t-e78f6cb2605603963509755348a45c3bf8a453ddaeab545b6c66ca120bc6a9633</cites><orcidid>0000-0003-1693-3553 ; 0000-0002-1842-1968 ; 0000-0001-8361-8778 ; 0000-0001-9332-2524</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37590964$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dogra, Prerna</creatorcontrib><creatorcontrib>Šambula, Lana</creatorcontrib><creatorcontrib>Saini, Jasmine</creatorcontrib><creatorcontrib>Thangamuthu, Karthik</creatorcontrib><creatorcontrib>Athimulam, Shobana</creatorcontrib><creatorcontrib>Delivanis, Danae A</creatorcontrib><creatorcontrib>Baikousi, Dimitra A</creatorcontrib><creatorcontrib>Nathani, Rohit</creatorcontrib><creatorcontrib>Zhang, Catherine D</creatorcontrib><creatorcontrib>Genere, Natalia</creatorcontrib><creatorcontrib>Salman, Zara</creatorcontrib><creatorcontrib>Turcu, Adina F</creatorcontrib><creatorcontrib>Ambroziak, Urszula</creatorcontrib><creatorcontrib>Garcia, Raul G</creatorcontrib><creatorcontrib>Achenbach, Sara J</creatorcontrib><creatorcontrib>Atkinson, Elizabeth J</creatorcontrib><creatorcontrib>Singh, Sumitabh</creatorcontrib><creatorcontrib>LeBrasseur, Nathan K</creatorcontrib><creatorcontrib>Kastelan, Darko</creatorcontrib><creatorcontrib>Bancos, Irina</creatorcontrib><title>High prevalence of frailty in patients with adrenal adenomas and adrenocortical hormone excess: a cross-sectional multi-centre study with prospective enrolment</title><title>European journal of endocrinology</title><addtitle>Eur J Endocrinol</addtitle><description>Frailty, characterized by multi-system 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 sub-type) and examine association between FI and performance-based measures of physical function.
Multi-centre, cross-sectional study (March 2019-August 2022).
Adult patients with adrenal disorders (non-functioning 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.
Compared to referent subjects (n = 89), patients with adrenal disorders (n = 520) showed increased age, sex, and body mass index-adjusted prevalence of frailty (CS [odds ratio-OR 19.2, 95% confidence interval-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 < .001).
Whilst frailty prevalence was highest in patients with adrenocortical hormone excess, even patients with NFA demonstrated an increased prevalence compared to the referent population. Future longitudinal studies are needed to evaluate the impact of various management strategies on frailty.</description><subject>Adenoma - epidemiology</subject><subject>Adrenocortical Adenoma</subject><subject>Adult</subject><subject>Cross-Sectional Studies</subject><subject>Cushing Syndrome</subject><subject>Dexamethasone</subject><subject>Frailty - epidemiology</subject><subject>Hand Strength</subject><subject>Humans</subject><subject>Hydrocortisone</subject><subject>Prevalence</subject><subject>Prospective Studies</subject><issn>0804-4643</issn><issn>1479-683X</issn><issn>1479-683X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kU9P3DAQxa2Kqiy0V46Vj1yyOOs_SXqrEJRKSFxA4hZNnAlr5Nip7SzdT8NXrbfZ9vRG4997GusRclGydckafoWv6Hp_ZXfQlyX_QFalqJpC1fz5hKxYzUQhlOCn5CzGV8bKPLNP5JRXsmGNEivyfmdetnQKuAOLTiP1Ax0CGJv21Dg6QTLoUqRvJm0p9AEd2Kzo_AiRguuXpdc-JKPz29aH0Tuk-FtjjN8oUB18jEVEnYw_uMfZJlPoHBuQxjT3-yV9ytx0oHbZ7YK3Y0Y-k48D2IhfjnpOnm5vHq_vivuHHz-vv98XmnOZCqzqQeluo5hUjDeKS9ZUUnJRg5Cad8NBed8DQieF7JRWSkO5YZ1WkHF-Ti6X3HzFrxljakcTNVoLDv0c200teSM2tagyul7Qvx8LOLRTMCOEfVuy9lBKu5TSHkvJhq_H7Lkbsf-P_2uB_wFeYI8S</recordid><startdate>20230901</startdate><enddate>20230901</enddate><creator>Dogra, Prerna</creator><creator>Šambula, Lana</creator><creator>Saini, Jasmine</creator><creator>Thangamuthu, Karthik</creator><creator>Athimulam, Shobana</creator><creator>Delivanis, Danae A</creator><creator>Baikousi, Dimitra A</creator><creator>Nathani, Rohit</creator><creator>Zhang, Catherine D</creator><creator>Genere, Natalia</creator><creator>Salman, Zara</creator><creator>Turcu, Adina F</creator><creator>Ambroziak, Urszula</creator><creator>Garcia, Raul G</creator><creator>Achenbach, Sara J</creator><creator>Atkinson, Elizabeth J</creator><creator>Singh, Sumitabh</creator><creator>LeBrasseur, Nathan K</creator><creator>Kastelan, Darko</creator><creator>Bancos, Irina</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1693-3553</orcidid><orcidid>https://orcid.org/0000-0002-1842-1968</orcidid><orcidid>https://orcid.org/0000-0001-8361-8778</orcidid><orcidid>https://orcid.org/0000-0001-9332-2524</orcidid></search><sort><creationdate>20230901</creationdate><title>High prevalence of frailty in patients with adrenal adenomas and adrenocortical hormone excess: a cross-sectional multi-centre study with prospective enrolment</title><author>Dogra, Prerna ; Šambula, Lana ; Saini, Jasmine ; Thangamuthu, Karthik ; Athimulam, Shobana ; Delivanis, Danae A ; Baikousi, Dimitra A ; Nathani, Rohit ; Zhang, Catherine D ; Genere, Natalia ; Salman, Zara ; Turcu, Adina F ; Ambroziak, Urszula ; Garcia, Raul G ; Achenbach, Sara J ; Atkinson, Elizabeth J ; Singh, Sumitabh ; LeBrasseur, Nathan K ; Kastelan, Darko ; Bancos, Irina</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c335t-e78f6cb2605603963509755348a45c3bf8a453ddaeab545b6c66ca120bc6a9633</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adenoma - epidemiology</topic><topic>Adrenocortical Adenoma</topic><topic>Adult</topic><topic>Cross-Sectional Studies</topic><topic>Cushing Syndrome</topic><topic>Dexamethasone</topic><topic>Frailty - epidemiology</topic><topic>Hand Strength</topic><topic>Humans</topic><topic>Hydrocortisone</topic><topic>Prevalence</topic><topic>Prospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dogra, Prerna</creatorcontrib><creatorcontrib>Šambula, Lana</creatorcontrib><creatorcontrib>Saini, Jasmine</creatorcontrib><creatorcontrib>Thangamuthu, Karthik</creatorcontrib><creatorcontrib>Athimulam, Shobana</creatorcontrib><creatorcontrib>Delivanis, Danae A</creatorcontrib><creatorcontrib>Baikousi, Dimitra A</creatorcontrib><creatorcontrib>Nathani, Rohit</creatorcontrib><creatorcontrib>Zhang, Catherine D</creatorcontrib><creatorcontrib>Genere, Natalia</creatorcontrib><creatorcontrib>Salman, Zara</creatorcontrib><creatorcontrib>Turcu, Adina F</creatorcontrib><creatorcontrib>Ambroziak, Urszula</creatorcontrib><creatorcontrib>Garcia, Raul G</creatorcontrib><creatorcontrib>Achenbach, Sara J</creatorcontrib><creatorcontrib>Atkinson, Elizabeth J</creatorcontrib><creatorcontrib>Singh, Sumitabh</creatorcontrib><creatorcontrib>LeBrasseur, Nathan K</creatorcontrib><creatorcontrib>Kastelan, Darko</creatorcontrib><creatorcontrib>Bancos, Irina</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of endocrinology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dogra, Prerna</au><au>Šambula, Lana</au><au>Saini, Jasmine</au><au>Thangamuthu, Karthik</au><au>Athimulam, Shobana</au><au>Delivanis, Danae A</au><au>Baikousi, Dimitra A</au><au>Nathani, Rohit</au><au>Zhang, Catherine D</au><au>Genere, Natalia</au><au>Salman, Zara</au><au>Turcu, Adina F</au><au>Ambroziak, Urszula</au><au>Garcia, Raul G</au><au>Achenbach, Sara J</au><au>Atkinson, Elizabeth J</au><au>Singh, Sumitabh</au><au>LeBrasseur, Nathan K</au><au>Kastelan, Darko</au><au>Bancos, Irina</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High prevalence of frailty in patients with adrenal adenomas and adrenocortical hormone excess: a cross-sectional multi-centre study with prospective enrolment</atitle><jtitle>European journal of endocrinology</jtitle><addtitle>Eur J Endocrinol</addtitle><date>2023-09-01</date><risdate>2023</risdate><volume>189</volume><issue>3</issue><spage>318</spage><epage>326</epage><pages>318-326</pages><issn>0804-4643</issn><issn>1479-683X</issn><eissn>1479-683X</eissn><abstract>Frailty, characterized by multi-system 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 sub-type) and examine association between FI and performance-based measures of physical function.
Multi-centre, cross-sectional study (March 2019-August 2022).
Adult patients with adrenal disorders (non-functioning 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.
Compared to referent subjects (n = 89), patients with adrenal disorders (n = 520) showed increased age, sex, and body mass index-adjusted prevalence of frailty (CS [odds ratio-OR 19.2, 95% confidence interval-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 < .001).
Whilst frailty prevalence was highest in patients with adrenocortical hormone excess, even patients with NFA demonstrated an increased prevalence compared to the referent population. Future longitudinal studies are needed to evaluate the impact of various management strategies on frailty.</abstract><cop>England</cop><pmid>37590964</pmid><doi>10.1093/ejendo/lvad113</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-1693-3553</orcidid><orcidid>https://orcid.org/0000-0002-1842-1968</orcidid><orcidid>https://orcid.org/0000-0001-8361-8778</orcidid><orcidid>https://orcid.org/0000-0001-9332-2524</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adenoma - epidemiology Adrenocortical Adenoma Adult Cross-Sectional Studies Cushing Syndrome Dexamethasone Frailty - epidemiology Hand Strength Humans Hydrocortisone Prevalence Prospective Studies |
| title | High prevalence of frailty in patients with adrenal adenomas and adrenocortical hormone excess: a cross-sectional multi-centre study with prospective enrolment |
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