Airflow limitation is underrecognized in well-functioning older people

Grant W. Waterer, Jim Wan, Stephen B. Kritchevsky, Richard G. Wunderink, Suzy Satterfield, Douglas C. Bauer, Anne B. Newman, Dennis R. Taaffe, Robert L. Jensen, Robert O. Crapo

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

OBJECTIVES: Dyspnea is a common symptom in older people. A reduced forced expiratory volume in 1 second (FEV 1 ) is associated with a higher mortality rate from cardiovascular and respiratory disease, and increased admissions to hospitals. Underrecognized or undertreated airflow limitation may exacerbate the problem. The purpose of this study was to assess the prevalence and treatment of airflow limitation in a cohort of well-functioning older people. DESIGN: Cross-sectional study. SETTING: Baseline of a clinical-epidemiological study of incident functional limitation. PARTICIPANTS: Participants attended the baseline examination of the Health, Aging, and Body Composition study, a prospective cohort study of 3,075 well-functioning subjects age 70 to 79. MEASUREMENTS: Demographic and clinical data were collected by interview. Spirometry was performed unless contraindicated and repeated until three acceptable sets of flow-volume loops were obtained. Patients on bronchodilator medications had spirometry performed posttherapy. Blinded readers assessed the flow-volume loops, and inadequate tests were omitted from analysis. Airflow limitation was defined as a reduced forced expiratory volume in 1 second/forced vital capacity (FEV 1 /FVC) as determined by age-, sex-, and race-normalized values. Severity of airflow limitation was defined by American Thoracic Society criteria. RESULTS: Two thousand four hundred eighty-five subjects (80.8%) had assessable spirometry and data on treatment and diagnosis (1,265 men, 1,220 women). The mean age was 73.6 years. Two hundred sixty-two subjects (10.5%) had airflow limitation; 43 (16.4%) of these never smoked. Only 37.4% of participants with airflow limitation and 55.6% of participants with severe airflow limitation reported a diagnosis of lung disease. Only 20.5% of subjects with at least moderate airflow limitation had used a bronchodilator in the previous 2 weeks. CONCLUSION: Despite their good functional status, airflow limitation was present, and underrecognized, in a considerable proportion of our older population. The low bronchodilator use suggests a significant reservoir of untreated disease. Physicians caring for older people need to be more vigilant for both the presence, and the need for treatment, of airflow limitation.

Original languageEnglish (US)
Pages (from-to)1032-1038
Number of pages7
JournalJournal of the American Geriatrics Society
Volume49
Issue number8
DOIs
StatePublished - Sep 12 2001

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Bronchodilator Agents
Spirometry
Forced Expiratory Volume
Disease Reservoirs
Vital Capacity
Body Composition
Dyspnea
Lung Diseases
Epidemiologic Studies
Cohort Studies
Cardiovascular Diseases
Therapeutics
Cross-Sectional Studies
Demography
Prospective Studies
Interviews
Physicians
Mortality
Health
Population

All Science Journal Classification (ASJC) codes

  • Geriatrics and Gerontology

Cite this

Waterer, G. W., Wan, J., Kritchevsky, S. B., Wunderink, R. G., Satterfield, S., Bauer, D. C., ... Crapo, R. O. (2001). Airflow limitation is underrecognized in well-functioning older people. Journal of the American Geriatrics Society, 49(8), 1032-1038. https://doi.org/10.1046/j.1532-5415.2001.49205.x

Airflow limitation is underrecognized in well-functioning older people. / Waterer, Grant W.; Wan, Jim; Kritchevsky, Stephen B.; Wunderink, Richard G.; Satterfield, Suzy; Bauer, Douglas C.; Newman, Anne B.; Taaffe, Dennis R.; Jensen, Robert L.; Crapo, Robert O.

In: Journal of the American Geriatrics Society, Vol. 49, No. 8, 12.09.2001, p. 1032-1038.

Research output: Contribution to journalArticle

Waterer, GW, Wan, J, Kritchevsky, SB, Wunderink, RG, Satterfield, S, Bauer, DC, Newman, AB, Taaffe, DR, Jensen, RL & Crapo, RO 2001, 'Airflow limitation is underrecognized in well-functioning older people', Journal of the American Geriatrics Society, vol. 49, no. 8, pp. 1032-1038. https://doi.org/10.1046/j.1532-5415.2001.49205.x
Waterer, Grant W. ; Wan, Jim ; Kritchevsky, Stephen B. ; Wunderink, Richard G. ; Satterfield, Suzy ; Bauer, Douglas C. ; Newman, Anne B. ; Taaffe, Dennis R. ; Jensen, Robert L. ; Crapo, Robert O. / Airflow limitation is underrecognized in well-functioning older people. In: Journal of the American Geriatrics Society. 2001 ; Vol. 49, No. 8. pp. 1032-1038.
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abstract = "OBJECTIVES: Dyspnea is a common symptom in older people. A reduced forced expiratory volume in 1 second (FEV 1 ) is associated with a higher mortality rate from cardiovascular and respiratory disease, and increased admissions to hospitals. Underrecognized or undertreated airflow limitation may exacerbate the problem. The purpose of this study was to assess the prevalence and treatment of airflow limitation in a cohort of well-functioning older people. DESIGN: Cross-sectional study. SETTING: Baseline of a clinical-epidemiological study of incident functional limitation. PARTICIPANTS: Participants attended the baseline examination of the Health, Aging, and Body Composition study, a prospective cohort study of 3,075 well-functioning subjects age 70 to 79. MEASUREMENTS: Demographic and clinical data were collected by interview. Spirometry was performed unless contraindicated and repeated until three acceptable sets of flow-volume loops were obtained. Patients on bronchodilator medications had spirometry performed posttherapy. Blinded readers assessed the flow-volume loops, and inadequate tests were omitted from analysis. Airflow limitation was defined as a reduced forced expiratory volume in 1 second/forced vital capacity (FEV 1 /FVC) as determined by age-, sex-, and race-normalized values. Severity of airflow limitation was defined by American Thoracic Society criteria. RESULTS: Two thousand four hundred eighty-five subjects (80.8{\%}) had assessable spirometry and data on treatment and diagnosis (1,265 men, 1,220 women). The mean age was 73.6 years. Two hundred sixty-two subjects (10.5{\%}) had airflow limitation; 43 (16.4{\%}) of these never smoked. Only 37.4{\%} of participants with airflow limitation and 55.6{\%} of participants with severe airflow limitation reported a diagnosis of lung disease. Only 20.5{\%} of subjects with at least moderate airflow limitation had used a bronchodilator in the previous 2 weeks. CONCLUSION: Despite their good functional status, airflow limitation was present, and underrecognized, in a considerable proportion of our older population. The low bronchodilator use suggests a significant reservoir of untreated disease. Physicians caring for older people need to be more vigilant for both the presence, and the need for treatment, of airflow limitation.",
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AU - Waterer, Grant W.

AU - Wan, Jim

AU - Kritchevsky, Stephen B.

AU - Wunderink, Richard G.

AU - Satterfield, Suzy

AU - Bauer, Douglas C.

AU - Newman, Anne B.

AU - Taaffe, Dennis R.

AU - Jensen, Robert L.

AU - Crapo, Robert O.

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N2 - OBJECTIVES: Dyspnea is a common symptom in older people. A reduced forced expiratory volume in 1 second (FEV 1 ) is associated with a higher mortality rate from cardiovascular and respiratory disease, and increased admissions to hospitals. Underrecognized or undertreated airflow limitation may exacerbate the problem. The purpose of this study was to assess the prevalence and treatment of airflow limitation in a cohort of well-functioning older people. DESIGN: Cross-sectional study. SETTING: Baseline of a clinical-epidemiological study of incident functional limitation. PARTICIPANTS: Participants attended the baseline examination of the Health, Aging, and Body Composition study, a prospective cohort study of 3,075 well-functioning subjects age 70 to 79. MEASUREMENTS: Demographic and clinical data were collected by interview. Spirometry was performed unless contraindicated and repeated until three acceptable sets of flow-volume loops were obtained. Patients on bronchodilator medications had spirometry performed posttherapy. Blinded readers assessed the flow-volume loops, and inadequate tests were omitted from analysis. Airflow limitation was defined as a reduced forced expiratory volume in 1 second/forced vital capacity (FEV 1 /FVC) as determined by age-, sex-, and race-normalized values. Severity of airflow limitation was defined by American Thoracic Society criteria. RESULTS: Two thousand four hundred eighty-five subjects (80.8%) had assessable spirometry and data on treatment and diagnosis (1,265 men, 1,220 women). The mean age was 73.6 years. Two hundred sixty-two subjects (10.5%) had airflow limitation; 43 (16.4%) of these never smoked. Only 37.4% of participants with airflow limitation and 55.6% of participants with severe airflow limitation reported a diagnosis of lung disease. Only 20.5% of subjects with at least moderate airflow limitation had used a bronchodilator in the previous 2 weeks. CONCLUSION: Despite their good functional status, airflow limitation was present, and underrecognized, in a considerable proportion of our older population. The low bronchodilator use suggests a significant reservoir of untreated disease. Physicians caring for older people need to be more vigilant for both the presence, and the need for treatment, of airflow limitation.

AB - OBJECTIVES: Dyspnea is a common symptom in older people. A reduced forced expiratory volume in 1 second (FEV 1 ) is associated with a higher mortality rate from cardiovascular and respiratory disease, and increased admissions to hospitals. Underrecognized or undertreated airflow limitation may exacerbate the problem. The purpose of this study was to assess the prevalence and treatment of airflow limitation in a cohort of well-functioning older people. DESIGN: Cross-sectional study. SETTING: Baseline of a clinical-epidemiological study of incident functional limitation. PARTICIPANTS: Participants attended the baseline examination of the Health, Aging, and Body Composition study, a prospective cohort study of 3,075 well-functioning subjects age 70 to 79. MEASUREMENTS: Demographic and clinical data were collected by interview. Spirometry was performed unless contraindicated and repeated until three acceptable sets of flow-volume loops were obtained. Patients on bronchodilator medications had spirometry performed posttherapy. Blinded readers assessed the flow-volume loops, and inadequate tests were omitted from analysis. Airflow limitation was defined as a reduced forced expiratory volume in 1 second/forced vital capacity (FEV 1 /FVC) as determined by age-, sex-, and race-normalized values. Severity of airflow limitation was defined by American Thoracic Society criteria. RESULTS: Two thousand four hundred eighty-five subjects (80.8%) had assessable spirometry and data on treatment and diagnosis (1,265 men, 1,220 women). The mean age was 73.6 years. Two hundred sixty-two subjects (10.5%) had airflow limitation; 43 (16.4%) of these never smoked. Only 37.4% of participants with airflow limitation and 55.6% of participants with severe airflow limitation reported a diagnosis of lung disease. Only 20.5% of subjects with at least moderate airflow limitation had used a bronchodilator in the previous 2 weeks. CONCLUSION: Despite their good functional status, airflow limitation was present, and underrecognized, in a considerable proportion of our older population. The low bronchodilator use suggests a significant reservoir of untreated disease. Physicians caring for older people need to be more vigilant for both the presence, and the need for treatment, of airflow limitation.

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