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Prevalence and risk factors of airflow obstruction in an elderly Chinese population

¹ Depts of Medicine and Therapeutics, ² Community and Family Medicine, and ³ Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong.

CORRESPONDENCE: D. S. C. Hui, Dept of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, 30–32 Ngan Shing Street, Shatin, New Territories, Hong Kong. Fax: 852 26489957. E-mail: dschui{at}cuhk.edu.hk

Keywords: Airflow obstruction, chronic obstructive lung disease, elderly, lung function

Received: April 18, 2008
Accepted July 19, 2008

It is common practice to use a forced expiratory volume in one second (FEV₁)/ forced vital capacity (FVC) ratio of <70% as evidence of airflow obstruction. As the FEV₁/FVC ratio falls with age, the lower limit of normal range (LLN), defined as the bottom 5% in a health reference population, of FEV₁/FVC ratio has been suggested as a better index to reduce over-diagnosis of chronic obstructive pulmonary disease (COPD), particularly in the elderly. However, there are no large scale studies that focus on the diagnosis of COPD in the elderly based on these definitions. The present prospective epidemiological study involved 1,149 elderly subjects aged 60 yrs in the community. Detailed questionnaires, pre- and post-bronchodilator spirometry were performed.

In total, 1,008 subjects (mean age 74.2±6.4 yrs; 271 males) completed satisfactory spirometry testing. Airflow obstruction was present in 25.9% as defined by the post-bronchodilator FEV₁/FVC ratio of <70% and in 12.4% defined by the LLN of FEV₁/FVC ratio. Moderate COPD, at least, was found in 14.0% of patients according to the post-bronchodilator FEV₁/FVC ratio of <70% and in 8.5% of patients according to LLN of FEV₁/FVC ratio.

In the present elderly Chinese population (mostly females, with low education level and previous exposure to biomass during formative years), the prevalence of chronic obstructive pulmonary disease varied markedly depending on definitions adopted. Further longitudinal studies are needed to determine the precise definition of chronic obstructive pulmonary disease.

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