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INTERNAL MEDICINE AND GERIATRICS / CLINICAL RESEARCH
Exploring the association between asthma and frailty: a cross-sectional and a bidirectional Mendelian randomization study
1
Department of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
2
Department of Neurology, Chinese PLA General Hospital, Beijing, China
3
Department of Anesthesiology, China-Japan Friendship Hospital, Beijing, China
4
Department of Lung transplantation, China-Japan Friendship Hospital, Beijing, China
Submission date: 2025-01-05
Final revision date: 2025-02-25
Acceptance date: 2025-03-28
Online publication date: 2025-05-18
Corresponding author
Cheng Ni
Department of Anesthesiology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China
Department of Anesthesiology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Observational studies suggest a potential association between asthma and frailty, but the causal relationship remains unclear. This study aimed to explore this association and determine its causal nature, with implications for targeted interventions that could improve patient management and quality of life.
Material and methods:
This study analyzed cross-sectional data from the National Health and Nutrition Examination Survey and included 29,589 participants. Multivariate logistic regression was used to assess the association between asthma and frailty, with propensity score matching for reliability. Bidirectional Mendelian randomization (MR) was used, with genetic variants associated with asthma and frailty obtained from the FinnGen database and a large GWAS meta-analysis. Causal effects were estimated using inverse variance weighting, with sensitivity analyses for robustness.
Results:
Cross-sectional analysis found a significant association between asthma and frailty (OR = 2.16; 95% CI: 2.01–2.31; p < 0.001). After adjusting for confounders using multiple methods, this association remained significant, with ORs ranging from 1.60 to 2.04, all p < 0.001. MR analysis revealed a bidirectional causal relationship: Genetically predicted asthma was significantly associated with an increased risk of frailty, with an OR of 1.091 (95% CI: 1.061–1.123). In the reverse direction analysis, genetic liability to frailty was also significantly associated with an increased risk of asthma, with an OR of 2.264 (95% CI: 1.503–3.409).
Conclusions:
This study suggests a bidirectional causal association between asthma and frailty. Routine screening for frailty in asthma patients is recommended, and further research is needed to explore the underlying mechanisms.
Observational studies suggest a potential association between asthma and frailty, but the causal relationship remains unclear. This study aimed to explore this association and determine its causal nature, with implications for targeted interventions that could improve patient management and quality of life.
Material and methods:
This study analyzed cross-sectional data from the National Health and Nutrition Examination Survey and included 29,589 participants. Multivariate logistic regression was used to assess the association between asthma and frailty, with propensity score matching for reliability. Bidirectional Mendelian randomization (MR) was used, with genetic variants associated with asthma and frailty obtained from the FinnGen database and a large GWAS meta-analysis. Causal effects were estimated using inverse variance weighting, with sensitivity analyses for robustness.
Results:
Cross-sectional analysis found a significant association between asthma and frailty (OR = 2.16; 95% CI: 2.01–2.31; p < 0.001). After adjusting for confounders using multiple methods, this association remained significant, with ORs ranging from 1.60 to 2.04, all p < 0.001. MR analysis revealed a bidirectional causal relationship: Genetically predicted asthma was significantly associated with an increased risk of frailty, with an OR of 1.091 (95% CI: 1.061–1.123). In the reverse direction analysis, genetic liability to frailty was also significantly associated with an increased risk of asthma, with an OR of 2.264 (95% CI: 1.503–3.409).
Conclusions:
This study suggests a bidirectional causal association between asthma and frailty. Routine screening for frailty in asthma patients is recommended, and further research is needed to explore the underlying mechanisms.
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