Respiratory impairment and dyspnea and their associations with physical inactivity and mobility in sedentary community-dwelling older persons
Carlos A Vaz Fragoso, Daniel P Beavers, John L Hankinson, Gail Flynn, Kathy Berra, Stephen B Kritchevsky, Christine K Liu, Mary M McDermott, Todd M Manini, W Jack Rejeski, Thomas M Gill, Lifestyle Interventions Independence for Elders Study Investigators, Marco Pahor, Jack M Guralnik, Christiaan Leeuwenburgh, Connie Caudle, Lauren Crump, Latonia Holmes, Jocelyn Lee, Ching-ju Lu, Michael E Miller, Mark A Espeland, Walter T Ambrosius, William Applegate, Don Babcock, Daniel P Beavers, Robert P Byington, Delilah Cook, Curt D Furberg, Jason Griffin, Lea N Harvin, Leora Henkin, John Hepler, Fang-Chi Hsu, Laura Lovato, Wesley Roberson, Julia Rushing, Scott Rushing, Cynthia L Stowe, Michael P Walkup, Don Hire, W Jack Rejeski, Jeffrey A Katula, Peter H Brubaker, Shannon L Mihalko, Janine M Jennings, Evan C Hadley, Sergei Romashkan, Denise E Bonds, Kushang V Patel, Mary M McDermott, Bonnie Spring, Joshua Hauser, Diana Kerwin, Kathryn Domanchuk, Rex Graff, Alvito Rego, Timothy S Church, Steven N Blair, Valerie H Myers, Ron Monce, Nathan E Britt, Melissa Nauta Harris, Ami Parks McGucken, Ruben Rodarte, Heidi K Millet, Catrine Tudor-Locke, Ben P Butitta, Sheletta G Donatto, Shannon H Cocreham, Abby C King, Cynthia M Castro, William L Haskell, Randall S Stafford, Leslie A Pruitt, Kathy Berra, Roger A Fielding, Miriam E Nelson, Sara C Folta, Edward M Phillips, Christine K Liu, Erica C McDavitt, Kieran F Reid, Won S Kim, Vince E Beard, Todd M Manini, Marco Pahor, Stephen D Anton, Susan Nayfield, Thomas W Buford, Michael Marsiske, Bhanuprasad D Sandesara, Jeffrey D Knaggs, Megan S Lorow, William C Marena, Irina Korytov, Holly L Morris, Margo Fitch, Floris F Singletary, Jackie Causer, Katie A Radcliff, Anne B Newman, Stephanie A Studenski, Bret H Goodpaster, Nancy W Glynn, Oscar Lopez, Neelesh K Nadkarni, Kathy Williams, Mark A Newman, George Grove, Janet T Bonk, Jennifer Rush, Piera Kost, Diane G Ives, Stephen B Kritchevsky, Anthony P Marsh, Tina E Brinkley, Jamehl S Demons, Kaycee M Sink, Kimberly Kennedy, Rachel Shertzer-Skinner, Abbie Wrights, Rose Fries, Deborah Barr, Thomas M Gill, Robert S Axtell, Susan S Kashaf, Nathalie de Rekeneire, Joanne M McGloin, Karen C Wu, Lynne P Iannone, Raeleen Mautner, Denise M Shepard, Barbara Fennelly, Theresa Sweeney Barnett, Sean N Halpin, Matthew J Brennan, Julie A Bugaj, Maria A Zenoni, Bridget M Mignosa, Jeff Williamson, Kaycee M Sink, Hugh C Hendrie, Stephen R Rapp, Joe Verghese, Nancy Woolard, Mark Espeland, Janine Jennings, Carl J Pepine, Mario Ariet, Eileen Handberg, Daniel Deluca, James Hill, Anita Szady, Geoffrey L Chupp, Gail M Flynn, Thomas M Gill, John L Hankinson, Carlos A Vaz Fragoso, Erik J Groessl, Robert M Kaplan, Carlos A Vaz Fragoso, Daniel P Beavers, John L Hankinson, Gail Flynn, Kathy Berra, Stephen B Kritchevsky, Christine K Liu, Mary M McDermott, Todd M Manini, W Jack Rejeski, Thomas M Gill, Lifestyle Interventions Independence for Elders Study Investigators, Marco Pahor, Jack M Guralnik, Christiaan Leeuwenburgh, Connie Caudle, Lauren Crump, Latonia Holmes, Jocelyn Lee, Ching-ju Lu, Michael E Miller, Mark A Espeland, Walter T Ambrosius, William Applegate, Don Babcock, Daniel P Beavers, Robert P Byington, Delilah Cook, Curt D Furberg, Jason Griffin, Lea N Harvin, Leora Henkin, John Hepler, Fang-Chi Hsu, Laura Lovato, Wesley Roberson, Julia Rushing, Scott Rushing, Cynthia L Stowe, Michael P Walkup, Don Hire, W Jack Rejeski, Jeffrey A Katula, Peter H Brubaker, Shannon L Mihalko, Janine M Jennings, Evan C Hadley, Sergei Romashkan, Denise E Bonds, Kushang V Patel, Mary M McDermott, Bonnie Spring, Joshua Hauser, Diana Kerwin, Kathryn Domanchuk, Rex Graff, Alvito Rego, Timothy S Church, Steven N Blair, Valerie H Myers, Ron Monce, Nathan E Britt, Melissa Nauta Harris, Ami Parks McGucken, Ruben Rodarte, Heidi K Millet, Catrine Tudor-Locke, Ben P Butitta, Sheletta G Donatto, Shannon H Cocreham, Abby C King, Cynthia M Castro, William L Haskell, Randall S Stafford, Leslie A Pruitt, Kathy Berra, Roger A Fielding, Miriam E Nelson, Sara C Folta, Edward M Phillips, Christine K Liu, Erica C McDavitt, Kieran F Reid, Won S Kim, Vince E Beard, Todd M Manini, Marco Pahor, Stephen D Anton, Susan Nayfield, Thomas W Buford, Michael Marsiske, Bhanuprasad D Sandesara, Jeffrey D Knaggs, Megan S Lorow, William C Marena, Irina Korytov, Holly L Morris, Margo Fitch, Floris F Singletary, Jackie Causer, Katie A Radcliff, Anne B Newman, Stephanie A Studenski, Bret H Goodpaster, Nancy W Glynn, Oscar Lopez, Neelesh K Nadkarni, Kathy Williams, Mark A Newman, George Grove, Janet T Bonk, Jennifer Rush, Piera Kost, Diane G Ives, Stephen B Kritchevsky, Anthony P Marsh, Tina E Brinkley, Jamehl S Demons, Kaycee M Sink, Kimberly Kennedy, Rachel Shertzer-Skinner, Abbie Wrights, Rose Fries, Deborah Barr, Thomas M Gill, Robert S Axtell, Susan S Kashaf, Nathalie de Rekeneire, Joanne M McGloin, Karen C Wu, Lynne P Iannone, Raeleen Mautner, Denise M Shepard, Barbara Fennelly, Theresa Sweeney Barnett, Sean N Halpin, Matthew J Brennan, Julie A Bugaj, Maria A Zenoni, Bridget M Mignosa, Jeff Williamson, Kaycee M Sink, Hugh C Hendrie, Stephen R Rapp, Joe Verghese, Nancy Woolard, Mark Espeland, Janine Jennings, Carl J Pepine, Mario Ariet, Eileen Handberg, Daniel Deluca, James Hill, Anita Szady, Geoffrey L Chupp, Gail M Flynn, Thomas M Gill, John L Hankinson, Carlos A Vaz Fragoso, Erik J Groessl, Robert M Kaplan
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.
© 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.
Source: PubMed