{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T11:44:45Z","timestamp":1791805485759,"version":"4.3.4"},"reference-count":40,"publisher":"European Respiratory Society (ERS)","issue":"5","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["5T32HL007427-42"],"award-info":[{"award-number":["5T32HL007427-42"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["75N92023D00011"],"award-info":[{"award-number":["75N92023D00011"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["U01 HL089856"],"award-info":[{"award-number":["U01 HL089856"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["U01 HL089897"],"award-info":[{"award-number":["U01 HL089897"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["ERJ Open Res"],"accepted":{"date-parts":[[2026,4,23]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Frailty, a state of reduced physiologic reserve, is associated with comorbid lung disease. Its relationship with lung function change over time and with lung computed tomography (CT) measurements is less clear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      COPDGene, a multicentre cohort study, enrolled adults aged 45\u201380\u2005years with a smoking history of a minimum of 10 pack-years. This study included participants with normal baseline 6-min walk distance (6MWD), spirometry at all three site visits and frailty assessment. The primary exposures were baseline quantitative CT measurements (airway wall thickening (Pi10), log (% emphysema), pulmonary artery (PA) enlargement and the ratio of pulmonary blood volume in vessels with a cross-sectional area &lt;5\u2005mm\n                      <jats:sup>2<\/jats:sup>\n                      to the total blood vessel volume (BV5\/TBV)) and spirometric decline over the 10-year study period. The primary outcomes were frailty and prefrailty at the 10-year follow-up (defined using a modified Fried Frailty Phenotype). Secondary analyses evaluated associations between inflammatory markers and frailty and for mediation of these associations by spirometric decline.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 2354 participants, 1200 (51%) were prefrail and 297 (13%) were frail at the 10-year follow-up. Baseline Pi10, log (% emphysema) and PA enlargement were significantly associated with increased odds of frailty (adjusted ORs, respectively: 1.52 (95% CI 1.30\u20131.77; p&lt;0.001), 1.38 (95% CI 1.14\u20131.67; p&lt;0.001) and 2.49 (95% CI 1.41\u20134.41; p=0.002)), as was lower BV5\/TBV, an indicator of pulmonary vascular pruning (OR 0.59, 95% CI 0.48\u20130.72; p&lt;0.001). Forced expiratory volume in 1\u2005s (FEV\n                      <jats:sub>1<\/jats:sub>\n                      ) decline was associated with increased odds of frailty (OR 1.47 (95% CI 1.30\u20131.65; p&lt;0.001) per 1%-per-year drop). White blood cell count (WBC) and neutrophil to lymphocyte (N:L) ratio were associated with frailty; this was partially mediated by spirometric decline.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In a population with a cigarette smoking history, lung function decline and CT measurements were associated with prospective frailty risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1183\/23120541.00470-2026","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T16:15:40Z","timestamp":1781194540000},"page":"00470-2026","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Lung function change and quantitative computed tomography measurements are associated with prospective 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