Connecting the Dots Between Asthma Control and Frailty in Older Adults With Moderate to Severe Asthma

the Editor:Frailty is a multidimensional syndrome characterized by cumulative multisystemic functional decline.Older adults with asthma are particularly vulnerable to frailty due to epigenetic and inflammatory immunosenescence-related changes.Frailty heavily burdens patients, increasing mortality, fall risk, and hospitalizations in later life. 1 We investigated the association between frailty and asthma control in older adults with asthma. MethodsWe conducted a cross-sectional study between January 2020 and November 2021 involving ambulatory older adults with moderate to severe asthma treated at the Programa de Controle da Asma in Salvador, Brazil.Participants aged $ 60 years who were diagnosed with asthma according to the Global Initiative for Asthma 2019 criteria 2 and agreed to participate were consecutively enrolled.Defining an older person as someone aged $ 60 years of age aligns with local realities and the World Health Organization's definition of older adults.Exclusion criteria included recent asthma exacerbation within the last 4 weeks, a tobacco use history of > 10 pack-years, and the presence of other pulmonary or extrapulmonary diseases that could interfere with asthma evaluation.All patients signed informed consent, and the local institutional review board approved the study (CAAE: 3.505.830-07/29/2019).The study protocol has been previously published and can be accessed for further details. 3 Data CollectionAsthma control was evaluated using the 6-domain Asthma Control Questionnaire (ACQ-6).The primary endpoint was frailty, assessed by the Fried frailty phenotype. 4Frailty was categorized based on the domains affected: $ 3 domains defined frailty, 1 or 2 domains indicated prefrailty, and the absence of any criteria classified participants as robust.