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J Am Med Dir Assoc. 2014 Sep;15(9):665-70. doi: 10.1016/j.jamda.2014.05.008. Epub 2014 Jun 25.

Combined reduced forced expiratory volume in 1 second (FEV1) and peripheral artery disease in sedentary elders with functional limitations.

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 S, 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

Clinical Epidemiology Research Center, VA Connecticut, West Haven, CT; Department of Medicine, Yale School of Medicine, New Haven, CT. Electronic address:
Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC.
Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC.
Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA; Klein Buendel, Inc., Golden, CO.
Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA; Section of Geriatrics, Department of Medicine, Boston University School of Medicine, Boston, MA.
Department of Aging and Geriatric Research, University of Florida, Gainesville, FL.
Department of Epidemiology and Medicine, University of Pittsburgh, Pittsburgh, PA.
Program on Prevention Outcomes and Practices, Stanford Prevention Research Center, Stanford School of Medicine, Stanford, CA.
Northwestern University Feinberg School of Medicine, Chicago, IL.
Department of Medicine, Yale School of Medicine, New Haven, CT.



Because they are potentially modifiable and may coexist, we evaluated the combined occurrence of a reduced forced expiratory volume in 1 second (FEV1) and peripheral artery disease (PAD), including its association with exertional symptoms, physical inactivity, and impaired mobility, in sedentary elders with functional limitations.


Cross sectional.


Lifestyle Interventions and Independence in Elder (LIFE) Study.


A total of 1307 sedentary community-dwelling persons, mean age 78.9, with functional limitations (Short Physical Performance Battery [SPPB] <10).


A reduced FEV1 was defined by a z-score less than -1.64 (<lower limit of normal), whereas PAD was defined by an ankle-brachial index less than 1.00. Exertional dyspnea was defined as moderate to severe (modified Borg index) immediately after a 400-meter walk test (400MWT). Exertional leg symptoms were established by the San Diego Claudication Questionnaire. Physical inactivity was evaluated by percent of accelerometry wear-time with activity less than 100 counts per minute (top quartile established high sedentary time). Mobility was evaluated by the 400MWT (gait speed <0.8 m/s defined as slow) and SPPB (≤ 7 defined moderate-to-severe mobility impairment).


A combined reduced FEV1 and PAD was established in 6.0% (78/1307) of participants. However, among those who had a reduced FEV1, 34.2% (78/228) also had PAD, whereas 20.8% (78/375) of those who had PAD also had a reduced FEV1. The 2 combined conditions were associated with exertional dyspnea (adjusted odds ratio [adjOR] 2.59 [1.20-5.60]) and slow gait speed (adjOR 3.15 [1.72-5.75]) but not with exertional leg symptoms, high sedentary time, and moderate-to-severe mobility impairment.


In sedentary community-dwelling elders with functional limitations, a reduced FEV1 and PAD frequently coexisted and, in combination, were strongly associated with exertional dyspnea and slow gait speed (a frailty indicator that increases the risk of deleterious outcomes).



FEV1; mobility; peripheral artery disease; sedentary

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