Interdependence of physical inactivity, loss of muscle mass and low dietary intake: Extrapulmonary manifestations in older chronic obstructive pulmonary disease patients

Abstract

Aim: Extrapulmonary manifestations, such as reductions in skeletal muscle and physical inactivity, are important clinical features of patients with chronic obstructive pulmonary disease (COPD), and might depend on the severity of COPD. As it is still unclear whether the relationship between muscle loss and physical inactivity is dominated by a disease-specific relationship or caused by patient factors, including physiological aging, we aimed to investigate the pulmonary or extrapulmonary factors associated with physical inactivity among older COPD patients.Methods: A total of 38 older male COPD patients (aged ≥65 years) were enrolled, and were evaluated cross-sectionally. Skeletal muscle mass was measured using bioelectrical impedance, and physical activity and energy intake were recorded for 2 weeks using a pedometer and diary.Results: Daily step counts were successfully evaluated in 28 participants (mean forced expiratory volume in 1 s [%predicted; %FEV 1 ]; 49.5%), and ranged widely. The mean step counts was 5166 steps/day, and found to have a significant relationship with dyspnea (r = À0.46), diffusing capacity (r = 0.47), %FEV1 (r = 0.44), skeletal muscle index (r = 0.59) and total dietary intake (r = 0.47), but not with age (P = 0.14). A stepwise multivariate analysis showed that the skeletal muscle index (β = 0.50) and total dietary intake (β = 0.35) were significant determinants of the daily step count (R 2 = 0.46, p < 0.01).Conclusions: Although various pulmonary factors are associated with daily physical activity, skeletal muscle mass and dietary intake are more closely correlated with physical activity in COPD patients. Because physical inactivity might be the strongest predictor of prognosis, the present results suggest that a comprehensive treatment strategy must be considered for older COPD patients to improve their extrapulmonary manifestations and pulmonary dysfunction.

<p>Evaluation of isokinetic muscle strength of upper limb and the relationship with pulmonary function and respiratory muscle strength in stable COPD patients</p>

“…Skeletal muscle function plays an important role in the exercise capacity and activities of daily living and can be used to predict the mortality of COPD patients independent of lung function 1,7,8. Currently, the primary means of assessing skeletal muscle function include isometric, isotonic, and isokinetic test.…”

Annual decline in arterial blood oxygen predicts development of chronic respiratory failure in COPD with mild hypoxaemia: A 6‐year follow‐up study

“…This negative result may be attributable to missing CT data and discrepancies in structure–function relationships. In our previous study, physical activity was significantly associated with diffusing capacity but not with LAA% . Fourth, we could not find an explanation for why ΔA‐aDO 2 was not a better index than ΔPaO 2 .…”

“…In our previous study, physical activity was significantly associated with diffusing capacity but not with LAA%. 26 Fourth, we could not find an explanation for why ΔA-aDO 2 was not a better index than ΔPaO 2 . Regarding Á V/ Á Q mismatch, we expected ΔA-aDO 2 to be associated more strongly with CRF development.…”

Frailty, a Dimension of Impaired Functional Status in Advanced COPD: Utility and Clinical Applicability

“…That functional status can be considered a marker of disease severity is not only obvious from the disease trajectory analysis, but also from data coming from various clinical studies on COPD patients: dyspnea severity was found to be inversely correlated with functional status and to be a major limiting factor to physical activity. Among extra-respiratory symptoms, fatigue was found to be associated with impaired exercise capacity in patients with more advanced COPD, irrespective of age or sex [ 5 , 6 , 7 , 8 ].…”