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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


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).


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.


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).


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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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 (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( 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 (Suppl 1), P11 (2015).

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