Effects of respiratory and non-respiratory factors on disability among older adults with airway obstruction: The Cardiovascular Health Study. (1st October 2013)

• Record Type: Journal Article
• Authors: Locke, Emily; Thielke, Stephen; Diehr, Paula; Wilsdon, Anthony G.; Graham Barr, R.; Hansel, Nadia; Kapur, Vishesh K.; Krishnan, Jerry; Enright, Paul; Heckbert, Susan R; Kronmal, Richard A.; Fan, Vincent S.
• Is Part Of: COPD. Volume 10:Number 5(2013:Oct.)
• Page Start: 588
• Page End: 596
• Publication Date: 2013-10-01
• Subjects: Lungs -- Diseases, Obstructive -- Periodicals; 616.24
• DOI: 10.3109/15412555.2013.781148
• Languages: English
• ISSNs: 1541-2555

Abstract

<abstract> <title>Abstract</title> <p> <bold>Background:</bold> High rates of disability associated with chronic airway obstruction may be caused by impaired pulmonary function, pulmonary symptoms, other chronic diseases, or systemic inflammation. <bold>Methods:</bold> We analyzed data from the Cardiovascular Health Study, a longitudinal cohort of 5888 older adults. Categories of lung function (normal; restricted; borderline, mild-moderate, and severe obstruction) were delineated by baseline spirometry (without bronchodilator). Disability-free years were calculated as total years alive and without self-report of difficulty performing <bold>&γτ;</bold>1 Instrumental Activities of Daily Living over 6 years of follow-up. Using linear regression, we compared disability-free years by lung disease category, adjusting for demographic factors, body mass index, smoking, cognition, and other chronic co-morbidities. Among participants with airflow obstruction, we examined the association of respiratory factors (FEV<sub>1</sub> and dyspnea) and non-respiratory factors (ischemic heart disease, congestive heart failure, diabetes, muscle weakness, osteoporosis, depression and cognitive impairment) on disability-free years. <italic>Results:</italic> The average disability free years were 4.0 out of a possible 6 years. Severe obstruction was associated with 1 fewer disability-free year compared to normal spirometry in the adjusted model. For the 1, 048 participants with airway obstruction, both respiratory factors (FEV<sub>1</sub> and dyspnea) and non-respiratory factors (heart disease, coronary artery disease, diabetes, depression, osteoporosis, cognitive function, and weakness) were associated with decreased disability-free years. <italic>Conclusions:</italic> Severe obstruction is associated with greater disability compared to patients with normal spirometery. Both respiratory and non-respiratory factors contribute to disability in older adults with abnormal spirometry.</p> </abstract>