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Associations Between Asthma Control and Airway Obstruction and Performance of Activities of Daily Living in Older Adults with Asthma
Author(s) -
Woods Eric C.,
O'Conor Rachel,
Martynenko Melissa,
Wolf Michael S.,
Wisnivesky Juan P.,
Federman Alex D.
Publication year - 2016
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.14108
Subject(s) - medicine , asthma , activities of daily living , confidence interval , odds ratio , physical therapy , prospective cohort study , cohort , airway obstruction , cohort study , gerontology , pediatrics , airway , surgery
Objectives To determine the effect of asthma on functional limitations of older adults in the United States. Design Analyses were conducted with data from the Asthma Beliefs and Literacy in the Elderly study, a prospective cohort study of people aged 60 and older with asthma. Setting Participants were recruited from urban primary care and pulmonary specialty practices in New York City and Chicago between 2010 and 2012. Participants Individuals aged 60 and older with asthma (380 women, 72 men, mean age 67.5 ± 6.8 (range 60–98), 40% Latino, 30% black). Measurements Characteristics of participants with and without activity of daily living ( ADL ) limitations were compared using the chi‐square test. Generalized estimating equations were used to model the relationships between poor asthma control (Asthma Control Questionnaire ( ACQ ) score >1.5) and severity of airway obstruction (forced expiratory volume in 1‐second ( FEV 1 )) and number of ADL limitations. Results Participants with one or more ADL limitations were more likely to be female (90% vs 81%, P = .02) and Latino (58% vs 32%, P < .001), have less than a high school education (53% vs 27%, P < .001) and an income of $1,350 per month or less (79% vs 46%, P < .001), and be unmarried (78% vs 64%, P = .003). In the adjusted analysis, poorer ACQ scores (odds ratio ( OR ) = 1.6, 95% confidence interval ( CI ) = 1.0–2.4; P = .05) but not severity of airway obstruction ( OR = 1.1, 95% CI = 0.6–1.9) was associated with greater ADL limitations. Conclusion Older adults reporting poor asthma control are more likely to have ADL limitations than those with controlled asthma, although one‐time spirometry may not adequately identify those at risk of physical impairment from asthma.