This prospective single-center cohort study evaluated the prevalence and concordance of frailty tools (Fried Frailty Phenotype, CGA-derived Frailty Index, and Clinical Frailty Scale) in 140 IPF patients aged ≥65, and assessed whether combining frailty measures with the GAP index improved prediction of all-cause mortality or acute exacerbation over a median follow-up of 465 days.
Frailty prevalence ranged from 16.4% (CGA-FI) to 22.3% (FFP); 25% of patients hit the composite outcome. CFS ≥5 (HR 3.94; 95% CI 1.81–8.58) and GAP stage II–III (HR 3.11; 95% CI 1.39–7.00) were independently predictive. The combined GAP-CFS model achieved a bootstrap Harrell C-index of 0.72 (95% CI 0.62–0.81).
Single-center design limits generalizability. Relatively small sample (n=140) with only 35 events may reduce statistical power. Median follow-up of ~15 months may miss longer-term outcomes.
Add the Clinical Frailty Scale (CFS) to routine GAP staging in older IPF patients — a CFS ≥5 nearly quadruples the risk of death or acute exacerbation. Use this combined GAP-CFS assessment to guide personalized, multidimensional care planning.
