{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T16:38:08Z","timestamp":1790267888498,"version":"4.1.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,3,15]],"date-time":"2019-03-15T00:00:00Z","timestamp":1552608000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pulm Med"],"published-print":{"date-parts":[[2019,12]]},"DOI":"10.1186\/s12890-019-0824-8","type":"journal-article","created":{"date-parts":[[2019,3,15]],"date-time":"2019-03-15T14:03:18Z","timestamp":1552658598000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Determinants of frailty in primary care patients with COPD: the Greek UNLOCK study"],"prefix":"10.1186","volume":"19","author":[{"given":"Despo","family":"Ierodiakonou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Kampouraki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Poulonirakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Polyvios","family":"Papadokostakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleftheria","family":"Lintovoi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitris","family":"Karanassos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyriakos","family":"Maltezis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Chorti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelos","family":"Petrovitsos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Dimopoulou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Hamind","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Gialamas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Polyxeni","family":"Athanasiou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasiliki","family":"Bempi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Lambraki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioanna","family":"Tsiligianni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,3,15]]},"reference":[{"key":"824_CR1","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1093\/gerona\/59.3.M255","volume":"59","author":"LP Fried","year":"2004","unstructured":"Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci. 2004;59:255\u201363.","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"824_CR2","first-page":"433","volume":"9","author":"X Chen","year":"2014","unstructured":"Chen X, Mao G, Leng SX. Frailty syndrome: an overview. Clin Interv Aging. 2014;9:433\u201341.","journal-title":"Clin Interv Aging"},{"key":"824_CR3","doi-asserted-by":"publisher","first-page":"M146","DOI":"10.1093\/gerona\/56.3.M146","volume":"56","author":"LP Fried","year":"2001","unstructured":"Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56:M146\u201356.","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"824_CR4","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1016\/j.jamda.2013.03.022","volume":"14","author":"JE Morley","year":"2013","unstructured":"Morley JE, Vellas B, van Kan GA, Anker SD, Bauer JM, Bernabei R, Cesari M, Chumlea WC, Doehner W, Evans J, et al. Frailty consensus: a call to action. J Am Med Dir Assoc. 2013;14:392\u20137.","journal-title":"J Am Med Dir Assoc"},{"key":"824_CR5","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1016\/S0140-6736(12)62167-9","volume":"381","author":"A Clegg","year":"2013","unstructured":"Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013;381:752\u201362.","journal-title":"Lancet"},{"key":"824_CR6","doi-asserted-by":"publisher","first-page":"1487","DOI":"10.1111\/j.1532-5415.2012.04054.x","volume":"60","author":"RM Collard","year":"2012","unstructured":"Collard RM, Boter H, Schoevers RA, Oude Voshaar RC. Prevalence of frailty in community-dwelling older persons: a systematic review. J Am Geriatr Soc. 2012;60:1487\u201392.","journal-title":"J Am Geriatr Soc"},{"key":"824_CR7","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1016\/j.jamda.2015.01.087","volume":"16","author":"J Woo","year":"2015","unstructured":"Woo J, Yu R, Wong M, Yeung F, Wong M, Lum C. Frailty screening in the community using the FRAIL scale. J Am Med Dir Assoc. 2015;16:412\u20139.","journal-title":"J Am Med Dir Assoc"},{"key":"824_CR8","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1016\/j.hrtlng.2012.07.004","volume":"42","author":"SK Park","year":"2013","unstructured":"Park SK, Richardson CR, Holleman RG, Larson JL. Frailty in people with COPD, using the National Health and nutrition evaluation survey dataset (2003-2006). Heart Lung. 2013;42:163\u201370.","journal-title":"Heart Lung"},{"key":"824_CR9","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1007\/s10654-014-9924-1","volume":"29","author":"L Lahousse","year":"2014","unstructured":"Lahousse L, Maes B, Ziere G, Loth DW, Verlinden VJ, Zillikens MC, Uitterlinden AG, Rivadeneira F, Tiemeier H, Franco OH, et al. Adverse outcomes of frailty in the elderly: the Rotterdam study. Eur J Epidemiol. 2014;29:419\u201327.","journal-title":"Eur J Epidemiol"},{"key":"824_CR10","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1111\/j.1532-5415.2006.00745.x","volume":"54","author":"J Walston","year":"2006","unstructured":"Walston J, Hadley EC, Ferrucci L, Guralnik JM, Newman AB, Studenski SA, Ershler WB, Harris T, Fried LP. Research agenda for frailty in older adults: toward a better understanding of physiology and etiology: summary from the American Geriatrics Society\/National Institute on Aging research conference on frailty in older adults. J Am Geriatr Soc. 2006;54:991\u20131001.","journal-title":"J Am Geriatr Soc"},{"key":"824_CR11","doi-asserted-by":"publisher","first-page":"1394","DOI":"10.1513\/AnnalsATS.201512-833FR","volume":"13","author":"JP Singer","year":"2016","unstructured":"Singer JP, Lederer DJ, Baldwin MR. Frailty in pulmonary and critical care medicine. Ann Am Thorac Soc. 2016;13:1394\u2013404.","journal-title":"Ann Am Thorac Soc"},{"key":"824_CR12","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/j.amjmed.2011.06.024","volume":"125","author":"CA Vaz Fragoso","year":"2012","unstructured":"Vaz Fragoso CA, Enright PL, McAvay G, Van Ness PH, Gill TM. Frailty and respiratory impairment in older persons. Am J Med. 2012;125:79\u201386.","journal-title":"Am J Med"},{"key":"824_CR13","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1016\/j.ccm.2013.10.007","volume":"35","author":"G Choudhury","year":"2014","unstructured":"Choudhury G, Rabinovich R, MacNee W. Comorbidities and systemic effects of chronic obstructive pulmonary disease. Clin Chest Med. 2014;35:101\u201330.","journal-title":"Clin Chest Med"},{"key":"824_CR14","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1183\/09031936.03.00405703","volume":"21","author":"AG Agusti","year":"2003","unstructured":"Agusti AG, Noguera A, Sauleda J, Sala E, Pons J, Busquets X. Systemic effects of chronic obstructive pulmonary disease. Eur Respir J. 2003;21:347\u201360.","journal-title":"Eur Respir J"},{"key":"824_CR15","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/j.chest.2018.02.014","volume":"154","author":"A Marengoni","year":"2018","unstructured":"Marengoni A, Vetrano DL, Manes-Gravina E, Bernabei R, Onder G, Palmer K. The relationship between COPD and frailty: a systematic review and meta-analysis of observational studies. Chest. 2018;154:21\u201340.","journal-title":"Chest"},{"key":"824_CR16","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1007\/BF03351076","volume":"23","author":"G Galizia","year":"2011","unstructured":"Galizia G, Cacciatore F, Testa G, Della-Morte D, Mazzella F, Langellotto A, Raucci C, Gargiulo G, Ferrara N, Rengo F, Abete P. Role of clinical frailty on long-term mortality of elderly subjects with and without chronic obstructive pulmonary disease. Aging Clin Exp Res. 2011;23:118\u201325.","journal-title":"Aging Clin Exp Res"},{"key":"824_CR17","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1177\/1753465817726314","volume":"11","author":"R Bernabeu-Mora","year":"2017","unstructured":"Bernabeu-Mora R, Garcia-Guillamon G, Valera-Novella E, Gimenez-Gimenez LM, Escolar-Reina P, Medina-Mirapeix F. Frailty is a predictive factor of readmission within 90 days of hospitalization for acute exacerbations of chronic obstructive pulmonary disease: a longitudinal study. Ther Adv Respir Dis. 2017;11:383\u201392.","journal-title":"Ther Adv Respir Dis"},{"key":"824_CR18","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1186\/s13690-015-0068-x","volume":"73","author":"F Buckinx","year":"2015","unstructured":"Buckinx F, Rolland Y, Reginster JY, Ricour C, Petermans J, Bruyere O. Burden of frailty in the elderly population: perspectives for a public health challenge. Arch Public Health. 2015;73:19.","journal-title":"Arch Public Health"},{"key":"824_CR19","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.cger.2017.09.004","volume":"34","author":"J Walston","year":"2018","unstructured":"Walston J, Buta B, Xue QL. Frailty screening and interventions: considerations for clinical practice. Clin Geriatr Med. 2018;34:25\u201338.","journal-title":"Clin Geriatr Med"},{"key":"824_CR20","doi-asserted-by":"publisher","first-page":"e101745","DOI":"10.1371\/journal.pone.0101745","volume":"9","author":"M Cesari","year":"2014","unstructured":"Cesari M, Demougeot L, Boccalon H, Guyonnet S, Abellan Van Kan G, Vellas B, Andrieu S. A self-reported screening tool for detecting community-dwelling older persons with frailty syndrome in the absence of mobility disability: the FiND questionnaire. PLoS One. 2014;9:e101745.","journal-title":"PLoS One"},{"key":"824_CR21","doi-asserted-by":"publisher","first-page":"408","DOI":"10.4104\/pcrj.2010.00084","volume":"19","author":"N Chavannes","year":"2010","unstructured":"Chavannes N, Stallberg B, Lisspers K, Roman M, Moran A, Langhammer A, Crockett A, Cave A, Williams S, Jones R, et al. UNLOCK: uncovering and noting long-term outcomes in COPD to enhance knowledge. Prim Care Respir J. 2010;19:408.","journal-title":"Prim Care Respir J"},{"key":"824_CR22","doi-asserted-by":"publisher","first-page":"648","DOI":"10.1183\/09031936.00102509","volume":"34","author":"PW Jones","year":"2009","unstructured":"Jones PW, Harding G, Berry P, Wiklund I, Chen WH, Kline Leidy N. Development and first validation of the COPD assessment test. Eur Respir J. 2009;34:648\u201354.","journal-title":"Eur Respir J"},{"key":"824_CR23","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1136\/thx.54.7.581","volume":"54","author":"JC Bestall","year":"1999","unstructured":"Bestall JC, Paul EA, Garrod R, Garnham R, Jones PW, Wedzicha JA. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax. 1999;54:581\u20136.","journal-title":"Thorax"},{"key":"824_CR24","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1164\/rccm.201701-0218PP","volume":"195","author":"CF Vogelmeier","year":"2017","unstructured":"Vogelmeier CF, Criner GJ, Martinez FJ, Anzueto A, Barnes PJ, Bourbeau J, Celli BR, Chen R, Decramer M, Fabbri LM, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report. GOLD executive summary. Am J Respir Crit Care Med. 2017;195:557\u201382.","journal-title":"Am J Respir Crit Care Med"},{"key":"824_CR25","unstructured":"The Improvement Hub (ihub). Frailty screening and assessment tools comparator. Healthcare improvement Scotland 2017."},{"key":"824_CR26","doi-asserted-by":"publisher","first-page":"1193","DOI":"10.2147\/COPD.S134233","volume":"12","author":"P Limpawattana","year":"2017","unstructured":"Limpawattana P, Putraveephong S, Inthasuwan P, Boonsawat W, Theerakulpisut D, Chindaprasirt J. Frailty syndrome in ambulatory patients with COPD. Int J Chron Obstruct Pulmon Dis. 2017;12:1193\u20138.","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"824_CR27","doi-asserted-by":"publisher","first-page":"988","DOI":"10.1136\/thoraxjnl-2016-208460","volume":"71","author":"M Maddocks","year":"2016","unstructured":"Maddocks M, Kon SS, Canavan JL, Jones SE, Nolan CM, Labey A, Polkey MI, Man WD. Physical frailty and pulmonary rehabilitation in COPD: a prospective cohort study. Thorax. 2016;71:988\u201395.","journal-title":"Thorax"},{"key":"824_CR28","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1177\/1479972316679664","volume":"14","author":"AE Bone","year":"2017","unstructured":"Bone AE, Hepgul N, Kon S, Maddocks M. Sarcopenia and frailty in chronic respiratory disease. Chron Respir Dis. 2017;14:85\u201399.","journal-title":"Chron Respir Dis"},{"key":"824_CR29","doi-asserted-by":"publisher","first-page":"1216","DOI":"10.1111\/j.1532-5415.2007.01259.x","volume":"55","author":"PM Cawthon","year":"2007","unstructured":"Cawthon PM, Marshall LM, Michael Y, Dam TT, Ensrud KE, Barrett-Connor E, Orwoll ES. Frailty in older men: prevalence, progression, and relationship with mortality. J Am Geriatr Soc. 2007;55:1216\u201323.","journal-title":"J Am Geriatr Soc"},{"key":"824_CR30","doi-asserted-by":"publisher","first-page":"1532","DOI":"10.1111\/j.1532-5415.2009.02394.x","volume":"57","author":"DK Kiely","year":"2009","unstructured":"Kiely DK, Cupples LA, Lipsitz LA. Validation and comparison of two frailty indexes: the MOBILIZE Boston study. J Am Geriatr Soc. 2009;57:1532\u20139.","journal-title":"J Am Geriatr Soc"},{"key":"824_CR31","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1093\/ageing\/afq034","volume":"39","author":"AJ Cruz-Jentoft","year":"2010","unstructured":"Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel JP, Rolland Y, Schneider SM, et al. Sarcopenia: European consensus on definition and diagnosis: report of the European working group on sarcopenia in older people. Age Ageing. 2010;39:412\u201323.","journal-title":"Age Ageing"},{"key":"824_CR32","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1186\/s12877-015-0134-9","volume":"15","author":"G Kojima","year":"2015","unstructured":"Kojima G, Iliffe S, Walters K. Smoking as a predictor of frailty: a systematic review. BMC Geriatr. 2015;15:131.","journal-title":"BMC Geriatr"},{"key":"824_CR33","unstructured":"Multimorbidity: Clinical assessment and management. NICE guideline [NG56]. 2016"},{"key":"824_CR34","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1016\/j.jamda.2012.04.012","volume":"13","author":"A Sinclair","year":"2012","unstructured":"Sinclair A, Morley JE, Rodriguez-Manas L, Paolisso G, Bayer T, Zeyfang A, Bourdel-Marchasson I, Vischer U, Woo J, Chapman I, et al. Diabetes mellitus in older people: position statement on behalf of the International Association of Gerontology and Geriatrics (IAGG), the European diabetes working Party for Older People (EDWPOP), and the international task force of experts in diabetes. J Am Med Dir Assoc. 2012;13:497\u2013502.","journal-title":"J Am Med Dir Assoc"}],"container-title":["BMC Pulmonary Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12890-019-0824-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12890-019-0824-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12890-019-0824-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,3,14]],"date-time":"2020-03-14T00:10:06Z","timestamp":1584144606000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpulmmed.biomedcentral.com\/articles\/10.1186\/s12890-019-0824-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,15]]},"references-count":34,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["824"],"URL":"https:\/\/doi.org\/10.1186\/s12890-019-0824-8","relation":{},"ISSN":["1471-2466"],"issn-type":[{"value":"1471-2466","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,15]]},"assertion":[{"value":"13 June 2018","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 February 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 March 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All subjects signed a consent form and ethical approval was provided by the University of Crete Ethics Committee.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors have no competing interests to declare, financial or otherwise related to this publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Publisher\u2019s Note"}}],"article-number":"63"}}