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. 2021 Apr-Jun;104(2):368504211013171.
doi: 10.1177/00368504211013171.

Ventilatory defects and treatable traits in very elderly patients

João Gaspar-Marques  1   2 , Teresa Palmeiro  1 , Iolanda Caires  1 , Paula Leiria Pinto  1   2 , Nuno Neuparth  1   2 , Pedro Carreiro-Martins  1   2
Affiliations

Ventilatory defects and treatable traits in very elderly patients

João Gaspar-Marques et al. Sci Prog. 2021 Apr-Jun.

Abstract

Though the approach used to classify chronic respiratory diseases is changing to a treatable-traits (TT) approach, data regarding very elderly patients is lacking. The objectives of this study were to assess TT frequency in very elderly patients and to study the link between extrapulmonary TT and ventilatory defects. Individuals (≥75 years) residing in elderly care centres answered a standardised questionnaire, underwent spirometry, atopy and fractional exhaled nitric oxide assessments and had their blood pressure and peripheral pulse oximetry measured. Pulmonary, extrapulmonary and behavioural TT were evaluated. Outcome variables were an airflow limitation (post-bronchodilator z-score FEV1/FVC<-1.64) and a restrictive spirometry pattern (z-score FEV1/FVC ≥ +1.64 and z-score FVC<-1.64). Seventy-two percent of the individuals who took part in the study (n = 234) were women, and the median age of participants was 86 (IQR: 7.4). At least one pulmonary TT was identified in 105 (44.9%) individuals. The most frequent extrapulmonary TTs were: persistent systemic inflammation (47.0%), anaemia (34.4%), depression (32.5%) and obesity (27.4). Airflow limitation was exclusively associated with smoking (OR 5.03; 95% CI 1.56-16.22). A restrictive spirometry pattern was associated with cognitive impairment (OR: 3.89; 95% CI: 1.55-9.79). A high frequency of various TTs was found. The novel association between a restrictive spirometry pattern and cognitive impairment highlights the urgency of clinical research on this vulnerable age group.

Keywords: Aged; comorbidity; lung diseases; obstructive; respiratory disorders.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Figures

Figure 1.
Figure 1.
Overlap of participants with airflow limitation, airway smooth muscle contraction and type-2 airway inflammation.
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