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Clin Respir J. 2008 Oct;2(4):208-13. doi: 10.1111/j.1752-699X.2008.00063.x.

Predicting inadequate spirometry technique and the use of FEV1/FEV3 as an alternative to FEV1/FVC for patients with mild cognitive impairment.

Author information

1
Department of Medicine, The Royal Bournemouth Hospital, Castle Lane East, Bournemouth, Dorset, UK. Stephen.allen@rbch.nhs.uk

Abstract

INTRODUCTION AND OBJECTIVES:

Some patients cannot perform forced vital capacity (FVC). We conducted a study to answer three questions: Can the ability to perform components of spirometry be predicted by the Mini Mental State Examination (MMSE)? What proportion of subjects can perform forced expiratory volume in 3 s (FEV3) but not FVC? Does the forced expiratory volume in 1 s (FEV1)/FEV3 ratio concord with FEV1/FVC ratio in patients with airflow obstruction?

METHODS:

We conducted a prospective observational study of 267 patients with a mean age of 79 years, including subjects with indicators of frailty. They performed spirometry and the MMSE. Spirometric recordings were compared to the American Thoracic Society 1994 criteria.

RESULTS:

FVC was achieved by 51% of patients. Inability to perform FVC was predicted by an MMSE < 24 (specificity 94%, sensitivity of 51%). An FEV1/FEV3 ratio < 80% matched a FEV1/FVC ratio < 70% (sensitivity 96%, specificity 97%). Twenty-five percent of subjects were able to reach FEV3 but not FVC; 14% of that group had an MMSE < 24. Subjects with an MMSE < 20 were unable reliably to perform any spirometry.

CONCLUSION:

Patients with an MMSE < 24 are usually unable to reach FVC reliably when tested on a single occasion, but some can reach FEV3. Patients with MMSE < 20 cannot do spirometry. An FEV1/FEV3 ratio < 80% can be used to help identify patients with airflow obstruction if they are unable to perform full spirometry to FVC.

[Indexed for MEDLINE]

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