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Volume 73 Supplement 1

Methods in Epidemiology Symposium

Respiratory function and its predictive value for health related outcomes in the BELFRAIL cohort

Background

Spirometry-based parameters of pulmonary function such as forced expiratory volume in 1 second (FEV1) have prognostic value beyond respiratory morbidity and mortality. Limited data are available on its prognostic value for adverse health outcomes in the growing group of very old adults (=80 years old). We investigate the prognostic value of FEV1 for adverse health outcomes in very old adults and assess the predictive value of airflow limitation (AL) for all-cause mortality and hospitalisation using two different approaches to cut-offs for FEV1/FVC (forced vital capacity).

Methods

In a Belgian population-based, prospective cohort of 501 very old adults, survival, Cox and logistic regression multivariable analysis assessed the association of FEV1 standardizations with 5-year all-cause mortality, first hospitalization at 3 years and decline in mental and physical functioning at around 2 years. Survival and Cox regression analysis assessed the association of AL by the 5th percentile of GLI 2012 z-scores (GLI-LLN) and fixed (0.70) cut-offs with all-cause mortality and first hospitalisation.

Results

Compared to the rest of the population, individuals in the lowest quartile of FEV1 standardizations had statistically significant increased adjusted risk for all-cause mortality (highest hazard ratio [HR] 1.96, 95% confidence interval [CI] 1.42-2.69) for FEV1/height cubed), first hospitalization (only FEV1/height cubed and height squared), decline in mental functioning (except FEV1 percent predicted). No FEV1 standardization was independently associated with physical decline. Only AL by GLI-LLN was independently associated with mortality (HR 2.10, 95% CI 1.30-3.38).

Conclusions

In a cohort of very old adults, low FEV1 was found to be an independent predictor of all-cause mortality, hospitalization and decline in mental functioning. Only AL by GLI-LLN independently predicted all-cause mortality without missing individuals with significantly higher all-cause mortality and hospitalisation. Further research is needed on FEV1 as a potential risk marker for adverse health outcomes in very old adults.

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Correspondence to Eralda Turkeshi.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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Turkeshi, E., Vaes, B., Andreeva, E. et al. Respiratory function and its predictive value for health related outcomes in the BELFRAIL cohort. Arch Public Health 73, P11 (2015). https://doi.org/10.1186/2049-3258-73-S1-P11

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Keywords

  • Forced Vital Capacity
  • Adjusted Risk
  • Forced Expiratory Volume
  • Adverse Health Outcome
  • Mental Functioning