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Expiratory flow limitation and obstruction in the elderly

¹ Laboratoire des Adaptations Physiologiques aux Activités Physiques EA 3813, Faculté des Sciences du Sport, Poitiers, and ² Laboratoire Santé Travail Environnement EA 3672, Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), ³ INSERM U593, ISPED, and ⁴ Laboratoire de Physiologie, EA518, Faculté Victor Pachon, Université Bordeaux 2, Bordeaux, France.

CORRESPONDENCE: C. de Bisschop, Laboratoire des Adaptations Physiologiques aux Activités Physiques, Faculté des Sciences du Sport, 4 allée Jean Monnet 86000 Poitiers, France. Fax: 33 549453396. E-mail: Claire.de-Bisschop{at}mshs.univ-poitiers.fr

Keywords: Elderly, expiratory flow limitation, negative expiratory pressure

Received: November 19, 2004
Accepted May 30, 2005

Elderly people commonly suffer from dyspnoea, which may stem from expiratory flow limitation (EFL). The relationship between EFL, as assessed by the negative expiratory pressure method and spirometric indices, was investigated in an elderly French population. Subjects, aged 66–88 yrs, filled in socio-demographic and standardised questionnaires, which dealt with: medical history, smoking status and respiratory symptoms. EFL measurements and forced expiratory manoeuvres were performed.

Validated measurements were obtained in 750 out of 1,318 subjects: 47% were EFL+ (EFL >0), with a higher prevalence in females than in males. EFL and forced expiratory volume in one second (FEV₁) were correlated with age. A total of 116, from the 750 subjects, with no medical history and no symptoms, served as a healthy group. The prevalence of EFL+ subjects increased with the grade of dyspnoea and was highest in respiratory and cardiac patients when compared with the healthy subjects. EFL did not correlate with FEV₁/forced vital capacity (FVC), the usual index of obstruction. Some elderly subjects (15%) with dyspnoea but with no medical history, mainly females with small FVC and normal FEV₁/FVC, had a greater EFL than the healthy subjects.

In elderly people, expiratory flow limitation measurements, along with the usual forced expiratory volume in one second/ forced vital capacity ratio, may be of value for the interpretation of dyspnoea.

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