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J Am Geriatr Soc. 2014 Apr;62(4):622-8. doi: 10.1111/jgs.12738. Epub 2014 Mar 17.

Respiratory impairment and dyspnea and their associations with physical inactivity and mobility in sedentary community-dwelling older persons.

Collaborators (149)

Pahor M, Guralnik JM, Leeuwenburgh C, Caudle C, Crump L, Holmes L, Lee J, Lu CJ, Miller ME, Espeland MA, Ambrosius WT, Applegate W, Babcock D, Beavers DP, Byington RP, Cook D, Furberg CD, Griffin J, Harvin LN, Henkin L, Hepler J, Hsu FC, Lovato L, Roberson W, Rushing J, Rushing S, Stowe CL, Walkup MP, Hire D, Rejeski W, Katula JA, Brubaker PH, Mihalko SL, Jennings JM, Hadley EC, Romashkan S, Bonds DE, Patel KV, McDermott MM, Spring B, Hauser J, Kerwin D, Domanchuk K, Graff R, Rego A, Church TS, Blair SN, Myers VH, Monce R, Britt NE, Harris MN, McGucken AP, Rodarte R, Millet HK, Tudor-Locke C, Butitta BP, Donatto SG, Cocreham SH, King AC, Castro CM, Haskell WL, Stafford RS, Pruitt LA, Berra K, Fielding RA, Nelson ME, Folta SC, Phillips EM, Liu CK, McDavitt EC, Reid KF, Kim WS, Beard VE, Manini TM, Pahor M, Anton SD, Nayfield S, Buford TW, Marsiske M, Sandesara BD, Knaggs JD, Lorow MS, Marena WC, Korytov I, Morris HL, Fitch M, Singletary FF, Causer J, Radcliff KA, Newman AB, Studenski SA, Goodpaster BH, Glynn NW, Lopez O, Nadkarni NK, Williams K, Newman MA, Grove G, Bonk JT, Rush J, Kost P, Ives DG, Kritchevsky SB, Marsh AP, Brinkley TE, Demons JS, Sink KM, Kennedy K, Shertzer-Skinner R, Wrights A, Fries R, Barr D, Gill TM, Axtell RS, Kashaf SS, de Rekeneire N, McGloin JM, Wu KC, Iannone LP, Mautner R, Shepard DM, Fennelly B, Barnett TS, Halpin SN, Brennan MJ, Bugaj JA, Zenoni MA, Mignosa BM, Williamson J, Sink KM, Hendrie HC, Rapp SR, Verghese J, Woolard N, Espeland M, Jennings J, Pepine CJ, Ariet M, Handberg E, Deluca D, Hill J, Szady A, Chupp GL, Flynn GM, Gill TM, Hankinson JL, Vaz Fragoso CA, Groessl EJ, Kaplan RM.

Author information

1
Veterans Affairs Connecticut, West Haven, Connecticut; Department of Medicine, School of Medicine, Yale University, New Haven, Connecticut.

Abstract

OBJECTIVES:

To evaluate the prevalence of respiratory impairment and dyspnea and their associations with objectively measured physical inactivity and performance-based mobility in sedentary older persons.

DESIGN:

Cross-sectional.

SETTING:

Lifestyle Interventions and Independence for Elders Study.

PARTICIPANTS:

Community-dwelling older persons (n = 1,635, mean age 78.9) who reported being sedentary (<20 min/wk of regular physical activity and <125 min/wk of moderate physical activity in past month).

MEASUREMENTS:

Respiratory impairment was defined as low ventilatory capacity (forced expiratory volume in 1 second less than lower limit of normal (LLN)) and respiratory muscle weakness (maximal inspiratory pressure <LLN). Dyspnea was defined as moderate to severe ratings on the modified Borg index, immediately after a 400-m walk test (400-MWT). Physical inactivity was defined according to high sedentary time as the highest quartile of participants with accelerometry-measured activity of <100 counts/min. Performance-based mobility was evaluated using the Short Physical Performance Battery (≤ 7 defined as moderate to severe mobility impairment) and 400-MWT gait speed (<0.8 m/s defined as slow).

RESULTS:

Prevalence rates were 17.7% for low ventilatory capacity, 14.7% for respiratory muscle weakness, 31.6% for dyspnea, 44.7% for moderate to severe mobility impairment and 43.6% for slow gait speed. Significant associations were found between low ventilatory capacity and slow gait speed (adjusted odds ratio (aOR) = 1.41, 95% confidence interval (CI) = 1.03-1.92), between respiratory muscle weakness and moderate to severe mobility impairment (aOR = 1.42, 95% CI = 1.03-1.95), and between dyspnea and high sedentary time (aOR = 1.98, 95% CI = 1.28-3.06) and slow gait speed (aOR = 1.70, 95% CI = 1.22-2.38).

CONCLUSION:

Respiratory impairment and dyspnea are prevalent in sedentary older persons and are associated with objectively measured physical inactivity and poor performance-based mobility. Because they are modifiable, respiratory impairment and dyspnea should be considered in the evaluation of sedentary older persons.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01072500.

KEYWORDS:

FEV1; dyspnea; mobility; respiratory muscle weakness; sedentary

PMID:
24635756
PMCID:
PMC3989438
DOI:
10.1111/jgs.12738
[Indexed for MEDLINE]
Free PMC Article

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