Relative and absolute lung function change in a general population aged 60–102 years
- 1Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
- 2Clinical Physiology and nuclear Medicine Unit, Department of Translational Medicine, Skåne University Hospital, Lund University, Malmö Sweden
- Johannes Luoto, Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Jan Waldenströms gata 35, SE-205 02, Malmö, Sweden. E-mail: johannes.luoto{at}med.lu.se
Abstract
Data on longitudinal lung function change in the elderly are scarce. Uncertainty remains about whether to use absolute or relative change and how it relates to subjects’ demographics.
We studied absolute and relative FEV1 and FVC change in a population-based geriatric sample using a repeated measurements model adjusted for age, sex, smoking habits, heart failure, hypertension, diabetes, coronary heart disease, educational level, occupation, alcohol consumption, CRP and BMI. 3736 participants aged 60–102 completed one to five spirometries during 13.5-years follow-up. Lung volumes, FEV1Q, GLI-2012 and NHANES III Z-scores were presented from 6932 spirometries.
Adjusted absolute change per year was −51.7 mL (−63.7, −39.9) for FEV1 and −56.2 mL (−73.6, −38.8) for FVC. Adjusted relative change per year was −2.97% (−3.53, −2.40) for FEV1 and −2.46% (−3.07, −1.85) for FVC. Risk factors for increased relative FVC and FEV1 decline were female sex, higher age, current smoking habits, elevated CRP (non-significant for FEV1, p 0.057) and low educational level. For increased absolute decline the risk factors were male sex and being a current smoker for FEV1 and low education for FVC. Relative but not absolute change correlated significantly with clinically relevant markers of functional status and may be superior to absolute change in risk factor analysis. Cross-sectional reduction in terms of FEV1Q was approximately 1 unit/10 years for both sexes. Proportions of subjects with results <LLN using NHANES III were close to anticipated but were 2 to 4 times higher than expected using GLI-2012.
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Conflict of interest: Dr. Luoto reports grants from Skåne County, during the conduct of the study.
Conflict of interest: Dr. Pihlsgård has nothing to disclose.
Conflict of interest: Dr. Wollmer reports grants from Swedish Heart and Lung Foundation, during the conduct of the study; personal fees from Astra Zeneca AB, outside the submitted work; In addition, Dr. Wollmer has a patent Device and method for pulmonary function measurement pending.
Conflict of interest: Dr. Elmståhl reports grants from Swedish Research Council, grants from Swedish Research Council, during the conduct of the study.
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