Restrictive pulmonary dysfunction at spirometry and mortality in the elderly (original) (raw)

2008, Respiratory Medicine

Objectives: To evaluate the association between pulmonary restriction and mortality in the elderly, taking into account potential confounders not considered in the past (disability, cognitive dysfunction, diabetes, and visceral obesity). Design: Longitudinal study. Setting: Community-based. Participants: Twelve hundred sixty-five patients (51.9% men) aged 65e97 years old from the Salute Respiratoria nell'Anziano (SaRA) Italian multicentric study. Measurements: Participants were divided in 4 groups: normal spirometry (NS): FEV1/ FVC 70%, FVC 80% of predicted; restrictive ventilatory pattern (RVP): FEV1/FVC 70%, FVC < 80%; obstructive ventilatory pattern (OVP): FEV1/FVC < 70%, FVC 80%, and mixed ventilatory pattern (MVP): FEV1/FVC < 70%, FVC < 80%. We calculated the association between restriction and mortality corrected for potential confounders using a multivariable Cox regression model. Results: We found a prevalence of RVP, OVP and MVP of 10.9%, 25.4%, and 17.3%, respectively. Compared to people with normal spirometric pattern, disability (19.6% vs. 10.1%), poor physical performance (35.4% vs. 22.3%), cognitive impairment (21.0% vs. 11.5%), increased waist circumference (62.1% and 26.8%), and kyphoscoliosis (56.8 and 13.5%) were more prevalent in the RVP group. After correction for potential confounders, RVP was associated with increased mortality (HR: 1.89; 95% CI: 1.15e3.11), as well as OVP (HR: 2.33; 95% CI: 1.58e 3.11) and MVP (HR: 2.60; 95% CI: 1.74e3.93). Other factors associated with mortality were disability (HR: 1.92; 95% CI: 1.35e2.72), poor physical performance (HR: 1.37; 95% CI: 1.01e1.85), a v a i l a b l e a t w w w . s c i e n c e d i r e c t . c o m j o u r n a l h o m e p a g e : w w w . e l s e v i e r . c o m / l o c a t e / r m e d Respiratory Medicine (2008) 102, 1349e1354