Respiratory Impairment and Dyspnea and Their Associations with Physical Inactivity and Mobility in Sedentary Community‐Dwelling Older Persons

Abstract

OBJECTIVES To evaluate the prevalence of respiratory impairment and dyspnea, and their associations with objectively-measured physical inactivity and performance-based mobility in sedentary older persons. DESIGN Cross-sectional. SETTING Lifestyle Interventions and Independence in Elder (LIFE) Study. PARTICIPANTS 1635 community-dwelling older persons, mean age 78.9, who reported a sedentary status (<20 minutes/week in the past month of regular physical activity and <125 minutes/week of moderate physical activity). MEASUREMENTS Respiratory impairment was defined by a reduced ventilatory capacity (forced expiratory volume in 1-second < lower limit of normal [LLN]) and respiratory muscle weakness (maximal inspiratory pressure <LLN). Dyspnea was defined as moderate-to-severe ratings on the modified Borg index, immediately after a 400-meter walk test (400MWT). Physical inactivity was defined by high sedentary time, as the highest quartile of participants with accelerometry-measured activity <100 counts/min. Performance-based mobility was evaluated by the Short Physical Performance Battery (<7 defined moderate-to-severe mobility impairment) and 400MWT gait speed (<0.8 meter/second was defined as slow). RESULTS Prevalence rates of reduced ventilatory capacity, respiratory muscle weakness, and dyspnea were 17.7%, 14.7%, and 31.6%, and of moderate-to-severe mobility impairment and slow gait speed were 44.7% and 43.6%, respectively. Significant associations were found between reduced ventilatory capacity and slow gait speed (adjusted odds ratio [95% confidence interval]: 1.41 [1.03, 1.92]), respiratory muscle weakness and moderate-to-severe mobility impairment (1.42 [1.03, 1.95]), and dyspnea with high sedentary time and slow gait speed (1.98 [1.28, 3.06] and 1.70 [1.22, 2.38], respectively). CONCLUSION Among sedentary older persons, respiratory impairment and dyspnea are prevalent and associated with objectively-measured physical inactivity or decreased performance-based mobility. Because they are modifiable, respiratory impairment and dyspnea should be considered in the evaluation of sedentary older persons.

The role of the inspiratory muscle weakness in functional capacity in hemodialysis patients

“…The association between MIP and FC has already been described in other health conditions [13, 14, 27–29]. In hemodialysis patients, the association between these variables has only been previously demonstrated by correlation analysis [16, 17, 30, 31].…”

Dyspnea in Community‐Dwelling Older Persons: A Multifactorial Geriatric Health Condition

“…Fourth, CHS had underrepresentation of persons aged 80 and older (mean age was 72.6) and no representation from Hispanics, limiting generalizability of the results for those populations. Last, the assembly of the CHS cohort in 1989/90 may raise concerns regarding timeliness of data, but this is unlikely to be a major limitation because the same impairments remain relevant to the current generation of older persons …”

“…Across 20 study populations of older persons, for example, the prevalence of moderate to severe dyspnea ranged from 17% to 62%, with the highest rates in those aged 80 and older . Moderate to severe dyspnea occurs at low exertional workloads, corresponding to activities of daily living, and is associated with poor functional status and quality of life and high healthcare costs, hospitalization rates, and mortality …”

“…2 Moderate to severe dyspnea occurs at low exertional workloads, corresponding to activities of daily living, and is associated with poor functional status and quality of life and high healthcare costs, hospitalization rates, and mortality. [1][2][3][4][5][6] The evaluation of dyspnea in older persons is traditionally focused on cardiorespiratory diseases, 1,7 rather than systematically evaluating the multiple impairments that often occur with advancing age and that may also contribute to dyspnea. 3,8 Studies in older persons showing that a spirometric impairment has a poor positive predictive value for dyspnea (and vice versa) 9 and that cardiac dysfunction is an infrequent cause of dyspnea 10 indicate the need for a comprehensive approach.…”

Prevalencia de síntomas respiratorios y riesgo de obstrucción al flujo aéreo en Ginebra - Valle del Cauca

“…La disnea como síntoma se encuentra asociado a enfermedad avanzada (22) y a peores desenlaces en patologías neoplásica (23)(24)(25)(26), respiratorias (27) y cardiovasculares de manera individual (28), así, como de ser un factor independiente asociado de morbilidad y mortalidad a nivel comunitario (29), en un estudio comunitario donde la prevalencia de disnea se reportó en un 32,3% en pacientes de 70 años, la mortalidad en los primeros dos años de los pacientes con disnea fue del 10,1% versus 3,4 % de los pacientes sin el síntoma, y el OR de mortalidad ajustado por edad y otras comorbilidades a diez años fue de 1,94 (IC95%: 1,11-3,38) (30).…”