Lung function decline and outcomes in an elderly population
Objective: To determine the risk factors for and outcomes associated with the rapid decline in lung function in a cohort of elderly US adults. Methods: Data from 4923 adult participants aged 65 years and older at baseline in the Cardiovascular Health Study were analysed. Subjects were classified usi...
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Published in | Thorax Vol. 61; no. 6; pp. 472 - 477 |
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Main Authors | , |
Format | Journal Article |
Language | English |
Published |
London
BMJ Publishing Group Ltd and British Thoracic Society
01.06.2006
BMJ BMJ Publishing Group LTD BMJ Group |
Subjects | |
Online Access | Get full text |
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Summary: | Objective: To determine the risk factors for and outcomes associated with the rapid decline in lung function in a cohort of elderly US adults. Methods: Data from 4923 adult participants aged 65 years and older at baseline in the Cardiovascular Health Study were analysed. Subjects were classified using a modification of the GOLD criteria for chronic obstructive pulmonary disease (COPD) and a “restricted” category (FEV1/FVC ⩾70% and FVC <80% predicted) was added. Cox proportional hazard models were used to determine the risk of lung function decline over 4 years on subsequent mortality and COPD hospital admissions after adjusting for age, race, sex, smoking status, and other factors. Results: Of the participants in the initial cohort, 3388 (68.8%) had spirometric tests at the year 4 visit. Participants with GOLD stages 3 or 4 COPD at baseline were less likely than normal subjects to have follow up spirometric tests (52.7% v 77.9%, p<0.01) and were more likely to be in the most rapidly declining quartile of FEV1 (28.2% v 21.3%, p<0.01) with an annual loss of FEV1 of at least 3.5%. Overall, being in the most rapidly declining quartile of FEV1 from baseline to year 4 was associated with an increased risk of admission to hospital for COPD (adjusted hazard ratio (HR) 1.6, 95% confidence interval (CI) 1.3 to 2.0) and all-cause death (adjusted HR 1.5, 95% CI 1.2 to 1.7) over an additional 7 years of follow up. Conclusion: More rapid decline in lung function is independently associated with a modest increased risk of hospital admissions and deaths from COPD in an elderly cohort of US participants. |
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Bibliography: | PMID:16517577 local:0610472 Correspondence to: Dr D M Mannino Division of Pulmonary and Critical Care Medicine, University of Kentucky Medical Center, 740 S Limestone, K-528, Lexington, KY 40536, USA; dmannino@uky.edu ark:/67375/NVC-F4WKC4CH-S istex:6F12623705F7A4AA7F71A47C5E5A9FE575CFC208 href:thoraxjnl-61-472.pdf ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0040-6376 1468-3296 |
DOI: | 10.1136/thx.2005.052449 |