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Respiratory Impairment and Dyspnea and Their Associations with Physical Inactivity and Mobility in Sedentary Community‐Dwelling Older Persons
Author(s) -
Vaz Fragoso Carlos A.,
Beavers Daniel P.,
Hankinson John L.,
Flynn Gail,
Berra Kathy,
Kritchevsky Stephen B.,
Liu Christine K.,
McDermott Mary M.,
Manini Todd M.,
Jack Rejeski W.,
Gill Thomas M.
Publication year - 2014
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.12738
Subject(s) - medicine , odds ratio , confidence interval , quartile , physical therapy , muscle weakness , weakness , vital capacity , surgery , diffusing capacity , lung , lung function
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 (a OR ) = 1.41, 95% confidence interval ( CI ) = 1.03–1.92), between respiratory muscle weakness and moderate to severe mobility impairment (a OR = 1.42, 95% CI = 1.03–1.95), and between dyspnea and high sedentary time (a OR = 1.98, 95% CI = 1.28–3.06) and slow gait speed (a OR = 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.