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Multicenter Study
. 2006 Jun;61(6):472-7.
doi: 10.1136/thx.2005.052449. Epub 2006 Mar 3.

Lung function decline and outcomes in an elderly population

D M Mannino  1 , K J Davis
Affiliations
Multicenter Study

Lung function decline and outcomes in an elderly population

D M Mannino et al. Thorax. 2006 Jun.

Abstract

Objective: To determine the risk factors for and outcomes associated with the rapid decline in lung function in a cohort of elderly US adults.

Methods: Data from 4923 adult participants aged 65 years and older at baseline in the Cardiovascular Health Study were analysed. Subjects were classified using a modification of the GOLD criteria for chronic obstructive pulmonary disease (COPD) and a "restricted" category (FEV1/FVC>or=70% and FVC<80% predicted) was added. Cox proportional hazard models were used to determine the risk of lung function decline over 4 years on subsequent mortality and COPD hospital admissions after adjusting for age, race, sex, smoking status, and other factors.

Results: Of the participants in the initial cohort, 3388 (68.8%) had spirometric tests at the year 4 visit. Participants with GOLD stages 3 or 4 COPD at baseline were less likely than normal subjects to have follow up spirometric tests (52.7% v 77.9%, p<0.01) and were more likely to be in the most rapidly declining quartile of FEV1 (28.2% v 21.3%, p<0.01) with an annual loss of FEV1 of at least 3.5%. Overall, being in the most rapidly declining quartile of FEV1 from baseline to year 4 was associated with an increased risk of admission to hospital for COPD (adjusted hazard ratio (HR) 1.6, 95% confidence interval (CI) 1.3 to 2.0) and all-cause death (adjusted HR 1.5, 95% CI 1.2 to 1.7) over an additional 7 years of follow up.

Conclusion: More rapid decline in lung function is independently associated with a modest increased risk of hospital admissions and deaths from COPD in an elderly cohort of US participants.

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Conflict of interest statement

Competing interests: DM serves on advisory boards for Boehringer Ingelheim, GlaxoSmithKline and Ortho Biotech, is on the speakers' bureau for Boehringer Ingelheim, Pfizer, and Dey, and has received research grants from GlaxoSmithKline and Pfizer. KD is a current employee of GlaxoSmithKline Research and Development and owns GlaxoSmithKline stock options.

References

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