Aging Clinical and Experimental Research · Jun 26, 2017
Prognostic value of short-term decline of forced expiratory volume in 1 s over height cubed (FEV₁/Ht³) in a cohort of adults aged 80 and over
By Hegendörfer E, Vaes B, Matheï C et al.
BACKGROUND: Forced expiratory volume in 1 s over height cubed (FEV₁/Ht³) is an FEV₁ expression that uses no reference values and is independently associated with adverse outcomes in older adults. No studies have reported on the prognostic value of its decline over time in adults aged 80 and over. AIM: To investigate the prognostic value of FEV₁/Ht³ decline for adverse outcomes in a cohort of adults aged 80 and over. METHODS: 328 community-dwelling adults aged 80 and over of the BELFRAIL prospective cohort had two valid FEV₁ measurements as part of their comprehensive geriatric assessment at baseline and follow-up (after 1.7 ± 0.21 years). Kaplan-Meier survival curves, Cox and logistic multivariable regression, assessed association of excessive decline of FEV₁/Ht³ (lowest quintile of percentage change) with all-cause mortality (3 years after follow-up assessment), time to first hospitalization (1 year), and new/ worsened disability in activities of daily living (ADL) at the follow-up assessment. RESULTS: Participants with excessive FEV₁/Ht³ decline had increased adjusted hazard ratio for all-cause death 1.61 (95% CI 1.01-2.55) and first hospitalization 1.71 (1.08-2.71) and increased odds ratio for new/worsened ADL disability at follow-up 2.02 (1.10-3.68) compared to the rest of the study population. CONCLUSIONS: Excessive, short-term decline in FEV₁/Ht³ was independently associated with all-cause mortality, time to first, unplanned hospitalization, and ADL disability in a cohort of adults aged 80 and over. This FEV₁ expression should be further investigated in studies of longitudinal FEV₁ change in older adults.