Association of Frailty with Ultrasound Parameters of Diaphragm Function in 153 Elderly Individuals

BACKGROUND Frailty is a common geriatric syndrome associated with increased risks of falls, disability, and mortality. It often impairs skeletal and respiratory muscle strength, including the diaphragm. This study aimed to evaluate the association between ultrasound parameters of diaphragm function and frailty, as assessed by the Fried frailty scale, in 153 elderly individuals. MATERIAL AND METHODS A total of 153 elderly patients (aged 60-85 years) treated at a single center between June 2022 and September 2024 were enrolled. Participants were classified into a frailty group (n=117) and a non-frailty group (n=36) using the Fried frailty phenotype. Diaphragm function was evaluated via ultrasonography, including diaphragm thickness fraction (DTF) and diaphragm movement during deep breathing. Clinical data were analyzed using Pearson correlation, multivariate logistic regression, and receiver operating characteristic (ROC) curve analysis. RESULTS The frailty group had a significantly higher mean age (P<0.001), greater prevalence of chronic diseases (P<0.05), and lower serum albumin levels (P<0.001). Diaphragm movement during deep breathing and DTF were significantly reduced in frail individuals (P<0.001), while diaphragm thickness showed no significant difference (P>0.05). A moderate positive correlation was observed between diaphragm contraction and frailty scores (r=0.672, P<0.001). ROC analysis of diaphragm parameters yielded an area under the curve (AUC) of 0.846. CONCLUSIONS Ultrasound parameters of diaphragm function are significantly associated with frailty in elderly patients. These findings support the potential utility of diaphragm ultrasonography in the clinical assessment of frailty.