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J Gerontol A Biol Sci Med Sci. 2016 Jul;71(7):929-34. doi: 10.1093/gerona/glv201. Epub 2015 Nov 2.

Aging-Related Considerations When Evaluating the Forced Expiratory Volume in 1 Second (FEV1) Over Time.

Author information

1
Veterans Affairs Clinical Epidemiology Research Center, West Haven, Connecticut. Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut. carlos.fragoso@yale.edu.
2
Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.
3
Department of Neurology, University of Tennessee Health Science Center, Memphis, Tennessee.
4
Harbor Hospital, National Institute on Aging, Baltimore, Maryland.
5
Veterans Affairs Clinical Epidemiology Research Center, West Haven, Connecticut. Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.

Abstract

BACKGROUND:

Forced expiratory volume in 1 second (FEV1) over time is commonly expressed in liters and percent predicted (%Pred), or alternatively in L/m(3) and Z-scores-which approach is more clinically meaningful has not been evaluated. Because it uniquely accounts for the effect of aging on FEV1 and spirometric performance, we hypothesized that the Z-score approach is more clinically meaningful, based on associations between cardiopulmonary predictors and FEV1 over time.

METHODS:

Using linear mixed-effects models and data from the Baltimore Longitudinal Study on Aging, including 501 white participants aged 40-95 who had completed at least three longitudinal spirometric assessments, we evaluated the associations between cardiopulmonary predictors (obesity, smoking status, hypertension, chronic bronchitis, diabetes mellitus, and myocardial infarction) and FEV1 over time, in liters, %Pred, L/m(3), and Z-scores.

RESULTS:

Mean baseline values for FEV1 were 3.240L, 96.4%Pred, 0.621L/m(3), and -0.239 as a Z-score (40.6th percentile). The annual decline in FEV1 was 0.040L, 0.234 %Pred, 0.007L/m(3), and 0.008 Z-score units. Baseline age was associated with FEV1 over time in liters and L/m(3) (p < .001), and included a time interaction for %Pred (p < .001), but was not associated with Z-scores (p = .933). The associations of cardiopulmonary predictors with FEV1 over time were all significant when using Z-scores (p < .05), but varied for other methods of expressing FEV1.

CONCLUSION:

A Z-score approach is more clinically meaningful when evaluating FEV1 over time, as it accounted for the effect of aging and was more frequently associated with multiple cardiopulmonary predictors.

KEYWORDS:

Aging; Cardiovascular diseases; Epidemiology; Lung diseases; Spirometry

PMID:
26525091
PMCID:
PMC4906321
DOI:
10.1093/gerona/glv201
[Indexed for MEDLINE]
Free PMC Article

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