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BMC Geriatrics
Published in: BMC Geriatrics 1/2015

Open Access 01-12-2015 | Research article

Short-term prognostic value of forced expiratory volume in 1 second divided by height cubed in a prospective cohort of people 80 years and older

Authors: Eralda Turkeshi, Bert Vaes, Elena Andreeva, Catharina Matheï, Wim Adriaensen, Gijs Van Pottelbergh, Jean-Marie Degryse

Published in: BMC Geriatrics | Issue 1/2015

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Abstract

Background

Spirometry-based parameters of pulmonary function such as forced expiratory volume in 1 second (FEV1) have prognostic value beyond respiratory morbidity and mortality. FEV1 divided by height cubed (FEV1/Ht3) has been found to be better at predicting all-cause mortality than the usual standardization as percentage of predicted "normal values" (FEV1%) and its use is independent of reference equations. Yet, limited data are available on the very old adults (80 years and older) and in association to other adverse health outcomes relevant for this age group. This study aims to investigate the short-term prognostic value of FEV1/Ht3 for all-cause mortality, hospitalization, physical and mental decline in a cohort of very old adults.

Methods

In a population-based prospective cohort study of 501 very old adults in Belgium, comprehensive geriatric assessment and spirometry were performed at baseline and after 1.7 ± 0.21 years. Kaplan-Meier curves for 3-year all-cause mortality and hospitalization rates and multivariable analysis adjusted for age, sex, smoking status, co-morbidities, anemia, high C reactive protein and creatinine levels examined the association of FEV1/Ht3 with all-cause mortality, unplanned hospitalization and decline in mental and physical functioning. Physical functioning was assessed by activities of daily living, a battery of physical performance tests and grip strength. Mental functioning was assessed with mini mental state examination and 15 items geriatric depression scale.

Results

Individuals in the lowest quartile of FEV1/Ht3 had a statistically significant increased adjusted risk for all-cause mortality (hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.10-2.60) and unplanned hospitalization (HR 1.65, 95% CI 1.21-2.25), as well as decline in physical (odds ratio [OR] 1.89, 95% CI 1.05-3.39) and mental functioning (OR 2.39, 95% CI 1.30-4.40) compared to the rest of the study population.

Conclusions

In a cohort of very old adults, low FEV1 expressed as FEV1/Ht3 was found to be a short-term predictor of all-cause mortality, hospitalization and decline in physical and mental functioning independently of age, smoking status, chronic lung disease and other co-morbidities. Further research is needed on FEV1/Ht3 as a potential risk marker for frailty and adverse health outcomes in this age group.
Literature
1.
2.
Burney PG, Hooper R. Forced vital capacity, airway obstruction and survival in a general population sample from the USA. Thorax. 2011;66:49–54.CrossRefPubMed
3.
Schunemann HJ, Dorn J, Grant BJ, Winkelstein Jr W, Trevisan M. Pulmonary function is a long-term predictor of mortality in the general population: 29-year follow-up of the Buffalo Health Study. Chest. 2000;118:656–64.CrossRefPubMed
4.
Sin DD, Wu L, Man SF. The relationship between reduced lung function and cardiovascular mortality: a population-based study and a systematic review of the literature. Chest. 2005;127:1952–9.CrossRefPubMed
5.
Hole DJ, Watt GC, Davey-Smith G, Hart CL, Gillis CR, Hawthorne VM. Impaired lung function and mortality risk in men and women: findings from the Renfrew and Paisley prospective population study. BMJ. 1996;313:711–5. discussion 715–716.CrossRefPubMedPubMedCentral
6.
Sabia S, Shipley M, Elbaz A, Marmot M, Kivimaki M, Kauffmann F, et al. Why does lung function predict mortality? results from the Whitehall II Cohort Study. Am J Epidemiol. 2010;172:1415–23.CrossRefPubMedPubMedCentral
7.
Singh-Manoux A, Dugravot A, Kauffmann F, Elbaz A, Ankri J, Nabi H, et al. Association of lung function with physical, mental and cognitive function in early old age. Age (Dordrecht, Netherlands). 2011;33:385–92.CrossRef
8.
Simpson CF, Punjabi NM, Wolfenden L, Shardell M, Shade DM, Fried LP. Relationship between lung function and physical performance in disabled older women. J Gerontol A Biol Sci Med Sci. 2005;60:350–4.CrossRefPubMed
9.
Thorpe Jr RJ, Szanton SL, Whitfield K. Association between lung function and disability in African-Americans. J Epidemiol Community Health. 2009;63:541–5.CrossRefPubMedPubMedCentral
10.
Fragoso CA, Gahbauer EA, Van Ness PH, Concato J, Gill TM. Peak expiratory flow as a predictor of subsequent disability and death in community-living older persons. J Am Geriatr Soc. 2008;56:1014–20.CrossRefPubMed
11.
Cook NR, Albert MS, Berkman LF, Blazer D, Taylor JO, Hennekens CH. Interrelationships of peak expiratory flow rate with physical and cognitive function in the elderly: MacArthur foundation studies of aging. J Gerontol A Biol Sci Med Sci. 1995;50A:M317–23.CrossRef
12.
Chyou PH, White LR, Yano K, Sharp DS, Burchfiel CM, Chen R, et al. Pulmonary function measures as predictors and correlates of cognitive functioning in later life. Am J Epidemiol. 1996;143:750–6.CrossRefPubMed
13.
Anstey KJ, Windsor TD, Jorm AF, Christensen H, Rodgers B. Association of pulmonary function with cognitive performance in early, middle and late adulthood. Gerontology. 2004;50:230–4.CrossRefPubMed
14.
Richards M, Strachan D, Hardy R, Kuh D, Wadsworth M. Lung function and cognitive ability in a longitudinal birth cohort study. Psychosom Med. 2005;67:602–8.CrossRefPubMed
15.
Guo X, Waern M, Sjogren K, Lissner L, Bengtsson C, Bjorkelund C, et al. Midlife respiratory function and Incidence of Alzheimer's disease: a 29-year longitudinal study in women. Neurobiol Aging. 2007;28:343–50.CrossRefPubMed
16.
Vidal JS, Aspelund T, Jonsdottir MK, Jonsson PV, Harris TB, Lopez OL, et al. Pulmonary function impairment may be an early risk factor for late-life cognitive impairment. J Am Geriatr Soc. 2013;61:79–83.CrossRefPubMedPubMedCentral
17.
Weuve J, Glymour MM, Hu H, Sparrow D, Spiro 3rd A, Vokonas PS, et al. Forced expiratory volume in 1 second and cognitive aging in men. J Am Geriatr Soc. 2011;59:1283–92.CrossRefPubMedPubMedCentral
18.
19.
Vaz Fragoso CA, Gill TM, McAvay G, Quanjer PH, Van Ness PH, Concato J. Respiratory impairment in older persons: when less means more. Am J Med. 2013;126:49–57.CrossRefPubMed
20.
Stanojevic S, Wade A, Stocks J. Reference values for lung function: past, present and future. Eur Respir J. 2010;36:12–9.CrossRefPubMed
21.
Quanjer PH, Stanojevic S, Cole TJ, Baur X, Hall GL, Culver BH, et al. Multi-ethnic reference values for spirometry for the 3-95-yr age range: the global lung function 2012 equations. Eur Respir J. 2012;40:1324–43.CrossRefPubMedPubMedCentral
22.
Loth DW, Ittermann T, Lahousse L, Hofman A, Leufkens HG, Brusselle GG, et al. Normal spirometry values in healthy elderly: the Rotterdam Study. Eur J Epidemiol. 2013;28:329–34.CrossRefPubMed
23.
Chinn S, Gislason T, Aspelund T, Gudnason V. Optimum expression of adult lung function based on all-cause mortality: results from the Reykjavik study. Respir Med. 2007;101:601–9.CrossRefPubMed
24.
Miller MR, Pedersen OF, Lange P, Vestbo J. Improved survival prediction from lung function data in a large population sample. Respir Med. 2009;103:442–8.CrossRefPubMed
25.
Miller MR, Pedersen OF. New concepts for expressing forced expiratory volume in 1 s arising from survival analysis. Eur Respir J. 2010;35:873–82.CrossRefPubMed
26.
Pedone C, Scarlata S, Scichilone N, Forastiere F, Bellia V, Antonelli-Incalzi R. Alternative ways of expressing FEV1 and mortality in elderly people with and without COPD. Eur Respir J. 2013;41:800–5.CrossRefPubMed
27.
Pedone C, Scarlata S, Zito A, Forastiere F, Scichilone N, Battaglia S, et al. Alternative ways of expressing forced expiratory volume in the first second and long-term mortality in elderly patients with asthma. Ann Allergy Asthma Immunol. 2013;111:382–6.CrossRefPubMed
28.
Vaes B, Pasquet A, Wallemacq P, Rezzoug N, Mekouar H, Olivier PA, et al. The BELFRAIL (BFC80+) study: a population-based prospective cohort study of the very elderly in Belgium. BMC Geriatr. 2010;10:39.CrossRefPubMedPubMedCentral
29.
Degryse J, Buffels J, Van Dijck Y, Decramer M, Nemery B. Accuracy of office spirometry performed by trained primary-care physicians using the MIR Spirobank hand-held spirometer. Respiration. 2012;83:543–52.CrossRefPubMed
30.
Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur Respir J. 2005;26:319–38.CrossRefPubMed
31.
McWhinnie JR. Disability assessment in population surveys: results of the O.E.C.D. Common Development Effort. Rev Epidemiol Sante Publique. 1981;29:413–9.PubMed
32.
Speer DC, Greenbaum PE. Five methods for computing significant individual client change and improvement rates: support for an individual growth curve approach. J Consult Clin Psychol. 1995;63:1044–8.CrossRefPubMed
33.
Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49:M85–94.CrossRefPubMed
34.
Guralnik JM, Ferrucci L, Simonsick EM, Salive ME, Wallace RB. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med. 1995;332:556–61.CrossRefPubMed
35.
Gawel J, Vengrow D, Collins J, Brown S, Buchanan A, Cook C. The short physical performance battery as a predictor for long term disability or institutionalization in the community dwelling population aged 65 years old or older. Phys Ther Rev. 2012;17:37–44.CrossRef
36.
Giampaoli S, Ferrucci L, Cecchi F, Lo Noce C, Poce A, Dima F, et al. Hand-grip strength predicts incident disability in non-disabled older men. Age Ageing. 1999;28:283–8.CrossRefPubMed
37.
Taekema DG, Gussekloo J, Maier AB, Westendorp RG, de Craen AJ. Handgrip strength as a predictor of functional, psychological and social health. A prospective population-based study among the oldest old. Age Ageing. 2010;39:331–7.CrossRefPubMed
38.
Tombaugh TN, McIntyre NJ. The mini-mental state examination: a comprehensive review. J Am Geriatr Soc. 1992;40:922–35.CrossRefPubMed
39.
Sheikh JI YJ: Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. In Clinical Gerontology: A Guide to Assessment and Intervention. Edited by TL B. NY: Haworth Press; 1986: 165–173
40.
de Craen AJ, Heeren TJ, Gussekloo J. Accuracy of the 15-item geriatric depression scale (GDS-15) in a community sample of the oldest old. Int J Geriatr Psychiatry. 2003;18:63–6.CrossRefPubMed
41.
Marc LG, Raue PJ, Bruce ML. Screening performance of the 15-item geriatric depression scale in a diverse elderly home care population. Am J Geriatr Psychiatry. 2008;16:914–21.CrossRefPubMedPubMedCentral
42.
Eisner MD, Iribarren C, Yelin EH, Sidney S, Katz PP, Ackerson L, et al. Pulmonary function and the risk of functional limitation in chronic obstructive pulmonary disease. Am J Epidemiol. 2008;167:1090–101.CrossRefPubMedPubMedCentral
43.
Santos-Eggimann B, Cuenoud P, Spagnoli J, Junod J. Prevalence of frailty in middle-aged and older community-dwelling Europeans living in 10 countries. J Gerontol A Biol Sci Med Sci. 2009;64:675–81.CrossRefPubMed
44.
Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56:M146–56.CrossRefPubMed
45.
Gill TM, Gahbauer EA, Allore HG, Han L. Transitions between frailty states among community-living older persons. Arch Intern Med. 2006;166:418–23.CrossRefPubMed
46.
Sternberg SA, Schwartz AW, Karunananthan S, Bergman H, Mark Clarfield A. The identification of frailty: a systematic literature review. J Am Geriatr Soc. 2011;59:2129–38.CrossRefPubMed
47.
Kjensli A, Ryg M, Falch JA, Armbrecht G, Diep LM, Eriksen EF, et al. Does body height reduction influence interpretation of lung function in COPD patients? Eur Respir J. 2010;36:540–8.CrossRefPubMed
Metadata
Title
Short-term prognostic value of forced expiratory volume in 1 second divided by height cubed in a prospective cohort of people 80 years and older
Authors
Eralda Turkeshi
Bert Vaes
Elena Andreeva
Catharina Matheï
Wim Adriaensen
Gijs Van Pottelbergh
Jean-Marie Degryse
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2015
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-015-0013-4

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