Peak expiratory flow, walking speed and survival in older adults: An 18-year longitudinal population-based study.


Journal

Experimental gerontology
ISSN: 1873-6815
Titre abrégé: Exp Gerontol
Pays: England
ID NLM: 0047061

Informations de publication

Date de publication:
01 07 2020
Historique:
received: 15 01 2020
revised: 28 03 2020
accepted: 28 03 2020
pubmed: 4 4 2020
medline: 28 4 2021
entrez: 4 4 2020
Statut: ppublish

Résumé

Peak expiratory flow (PEF) and walking speed (WS) have been proposed as indicators of robustness and are independent predictors of health-related outcomes. We aimed to investigate how the co-occurrence of respiratory and physical impairments changes as a function of age, and to quantify the association of the combination of low PEF and slow WS on survival in older people. This prospective study analyzes data from 2656 community-dwelling participants (age ≥ 60 years) from the SNAC-K study. At baseline, we assessed: (1) sociodemographic, lifestyle and medical data; (2) respiratory function, estimated through PEF and expressed as standardized residual (SR) percentile; and (3) WS at usual pace, categorized as no (>1.2 m/s), mild (0.8-1.2 m/s) and moderate-to-severe (<0.8 m/s) walking impairment. Participants' vital status over an 18-year follow-up was derived from registers. The association of different combinations of PEF and WS on median survival time was estimated through Laplace regression adjusted for potential confounders. Respiratory and walking impairments co-occurred more frequently with increasing age. Among individuals with PEF SR-percentiles < 10th, the percentage of moderate-to-severe walking impairment was 12.1% in sexagenarians, 35.7% in septuagenarians, and 75-80% in the oldest old. The greatest reduction in median survival time (-5.4 [95%CI: -6.4; -4.4] years, p < 0.001) was observed among people with combined respiratory and moderate-to-severe walking impairments, compared with those with no dysfunctions, who had a median survival time of 17.4 (95%CI: 17.0; 17.8) years. Impaired PEF and WS co-occur more frequently with advancing age, and their co-occurrence is associated with shorter survival.

Sections du résumé

BACKGROUND
Peak expiratory flow (PEF) and walking speed (WS) have been proposed as indicators of robustness and are independent predictors of health-related outcomes. We aimed to investigate how the co-occurrence of respiratory and physical impairments changes as a function of age, and to quantify the association of the combination of low PEF and slow WS on survival in older people.
METHODS
This prospective study analyzes data from 2656 community-dwelling participants (age ≥ 60 years) from the SNAC-K study. At baseline, we assessed: (1) sociodemographic, lifestyle and medical data; (2) respiratory function, estimated through PEF and expressed as standardized residual (SR) percentile; and (3) WS at usual pace, categorized as no (>1.2 m/s), mild (0.8-1.2 m/s) and moderate-to-severe (<0.8 m/s) walking impairment. Participants' vital status over an 18-year follow-up was derived from registers. The association of different combinations of PEF and WS on median survival time was estimated through Laplace regression adjusted for potential confounders.
RESULTS
Respiratory and walking impairments co-occurred more frequently with increasing age. Among individuals with PEF SR-percentiles < 10th, the percentage of moderate-to-severe walking impairment was 12.1% in sexagenarians, 35.7% in septuagenarians, and 75-80% in the oldest old. The greatest reduction in median survival time (-5.4 [95%CI: -6.4; -4.4] years, p < 0.001) was observed among people with combined respiratory and moderate-to-severe walking impairments, compared with those with no dysfunctions, who had a median survival time of 17.4 (95%CI: 17.0; 17.8) years.
CONCLUSIONS
Impaired PEF and WS co-occur more frequently with advancing age, and their co-occurrence is associated with shorter survival.

Identifiants

pubmed: 32243991
pii: S0531-5565(20)30041-3
doi: 10.1016/j.exger.2020.110941
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

110941

Informations de copyright

Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest None.

Auteurs

Caterina Trevisan (C)

Department of Medicine (DIMED), Geriatrics Division, University of Padova, Italy; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden. Electronic address: caterina.trevisan.5@phd.unipd.it.

Debora Rizzuto (D)

Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden.

Giuseppe Sergi (G)

Department of Medicine (DIMED), Geriatrics Division, University of Padova, Italy.

Stefania Maggi (S)

National Research Council, Neuroscience Institute, Padova, Italy.

Anna-Karin Welmer (AK)

Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Allied Health Professionals, Function Area Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden.

Davide Liborio Vetrano (DL)

Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Centro Medicina dell'Invecchiamento, IRCCS Fondazione Policlinico "A. Gemelli" and Catholic University of Rome, Italy.

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