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Forced expiratory volume in 1 second and cognitive aging in men.

ABSTRACT: To evaluate forced expiratory volume in 1 second (FEV(1) , a measure of overall lung function), long-term average FEV(1) , and rate of decline in FEV(1) in relation to cognition and cognitive decline in older men.Prospective observational study.Community-based population.Eight hundred sixty-four older men from the Normative Aging Study.Starting in 1984, participants underwent triennial clinical evaluations. Lung function assessments provided estimates of FEV(1) . Cognitive assessments entailing tests of several cognitive abilities began in 1993. FEV(1) measured approximately 12 years before baseline cognitive testing, average FEV(1) over the 12-year period, and rate of change in FEV(1) were all evaluated in relation to baseline and change in performance on the cognitive tests.In multivariable-adjusted analyses, associations between FEV(1) and baseline cognitive scores were mixed, although average FEV(1) predicted significantly better performance on tests of visuospatial ability (P=.04) and general cognition (P=.03). Higher FEV(1) was more consistently associated with slower cognitive decline, but only the association between historical FEV(1) and attention was significant (difference per standard deviation in FEV(1) =0.056, P=.05). Rate of FEV(1) decline was not consistently associated with cognitive function or decline. Findings were generally similar or stronger in men who had never smoked. To account for potential bias due to selective attrition, inverse probability of censoring weights were applied to the cognitive decline analyses, yielding slightly larger estimates; the inadequate prognostic power of the censoring models limited this approach.Overall, the data provide limited evidence of an inverse association between FEV(1) and cognitive aging.

SUBMITTER: Weuve J

PROVIDER: S-EPMC3758858 | biostudies-literature | 2011 Jul

REPOSITORIES: biostudies-literature

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Forced expiratory volume in 1 second and cognitive aging in men.

Weuve Jennifer J Glymour M Maria MM Hu Howard H Sparrow David D Spiro Avron A Vokonas Pantel S PS Litonjua Augusto A AA

Journal of the American Geriatrics Society 20110630 7

<h4>Objectives</h4>To evaluate forced expiratory volume in 1 second (FEV(1) , a measure of overall lung function), long-term average FEV(1) , and rate of decline in FEV(1) in relation to cognition and cognitive decline in older men.<h4>Design</h4>Prospective observational study.<h4>Setting</h4>Community-based population.<h4>Participants</h4>Eight hundred sixty-four older men from the Normative Aging Study.<h4>Measurements</h4>Starting in 1984, participants underwent triennial clinical evaluation ...[more]

PMID: 21718272

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Project description:Rationale: The American Thoracic Society (ATS)/European Respiratory Society defines a positive bronchodilator response (BDR) by a composite of BDR in either forced expiratory volume in 1 second (FEV1) and/or forced vital capacity (FVC) greater than or equal to 12% and 200 ml (ATS-BDR). We hypothesized that ATS-BDR components would be differentially associated with important chronic obstructive pulmonary disease (COPD) outcomes. Objectives: To examine whether ATS-BDR components are differentially associated with clinical, functional, and radiographic features in COPD. Methods: We included subjects with COPD enrolled in the COPDGene study. In the main analysis, we excluded subjects with self-reported asthma. We categorized BDR into the following: 1) No-BDR, no BDR in either FEV1 or FVC; 2) FEV1-BDR, BDR in FEV1 but no BDR in FVC; 3) FVC-BDR, BDR in FVC but no BDR in FEV1; and 4) Combined-BDR, BDR in both FEV1 and FVC. We constructed multivariable logistic, linear, zero-inflated negative binomial, and Cox hazards models to examine the association of BDR categories with symptoms, computed tomography findings, change in FEV1 over time, respiratory exacerbations, and mortality. We also created models using the ATS BDR definition (ATS-BDR) as the main independent variable. Results: Of 3,340 COPD subjects included in the analysis, 1,083 (32.43%) had ATS-BDR, 182 (5.45%) had FEV1-BDR, 522 (15.63%) had FVC-BDR, and 379 (11.34%) had Combined-BDR. All BDR categories were associated with FEV1 decline compared with No-BDR. Compared with No-BDR, both ATS-BDR and Combined-BDR were associated with higher functional residual capacity %predicted, greater internal perimeter of 10 mm, and greater 6-minute-walk distance. In contrast to ATS-BDR, Combined-BDR was independently associated with less emphysema (adjusted beta regression coefficient, -1.67; 95% confidence interval [CI], -2.68 to -0.65; P = 0.001), more frequent respiratory exacerbations (incidence rate ratio, 1.25; 95% CI, 1.03-1.50; P = 0.02) and severe exacerbations (incidence rate ratio, 1.34; 95% CI, 1.05-1.71; P = 0.02), and lower mortality (adjusted hazards ratio, 0.76; 95% CI, 0.58-0.99; P = 0.046). Sensitivity analysis that included subjects with self-reported history of asthma showed similar findings. Conclusions: BDR in both FEV1 and FVC indicates a COPD phenotype with asthma-like characteristics, and provides clinically more meaningful information than current definitions of BDR.

Project description:ObjectivesBecause 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.DesignCross sectional.SettingLifestyle Interventions and Independence in Elder (LIFE) Study.ParticipantsA total of 1307 sedentary community-dwelling persons, mean age 78.9, with functional limitations (Short Physical Performance Battery [SPPB] <10).MeasurementsA 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).ResultsA 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.ConclusionsIn 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).

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Forced expiratory volume in 1 second and cognitive aging in men.

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Forced expiratory volume in 1 second and cognitive aging in men.

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