%0 Journal Article
%T Diagnosis of airway obstruction in the elderly: contribution of the SARA study
%A Sorino C
%A Battaglia S
%A Scichilone N
%A Pedone C
%A Antonelli-Incalzi R
%A Sherrill D
%A Bellia V
%J International Journal of Chronic Obstructive Pulmonary Disease
%D 2012
%I 
%R http://dx.doi.org/10.2147/COPD.S31630
%X gnosis of airway obstruction in the elderly: contribution of the SARA study Original Research (2189) Total Article Views Authors: Sorino C, Battaglia S, Scichilone N, Pedone C, Antonelli-Incalzi R, Sherrill D, Bellia V Published Date June 2012 Volume 2012:7 Pages 389 - 395 DOI: http://dx.doi.org/10.2147/COPD.S31630 Received: 09 March 2012 Accepted: 15 April 2012 Published: 27 June 2012 Claudio Sorino,1,2 Salvatore Battaglia,1 Nicola Scichilone,1 Claudio Pedone,3 Raffaele Antonelli-Incalzi,3 Duane Sherrill,4 Vincenzo Bellia1 1Biomedical Department of Internal and Specialist Medicine, Section of Pulmonology, University of Palermo, Italy; 2Division of Pulmonology, S Anna Hospital, Como, Italy; 3Chair of Geriatrics, University Campus Bio-Medico, Roma, Italy; 4Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA Background: The choice between lower limit of normal or fixed value of forced expiratory volume in one second/forced vital capacity ratio (FEV1/FVC) < 0.70 as the criterion for confirming airway obstruction is an open issue. In this study, we compared the criteria of lower limit of normal and fixed FEV1/FVC for diagnosis of airway obstruction, with a focus on healthy elderly people. Methods: We selected 367 healthy nonsmoking subjects aged 65¨C93 years from 1971 participants in the population-based SARA (Salute Respiratoria nell¡¯Anziano, Italian for ¡°Respiratory Health in the Elderly¡±) study, analyzed their spirometric data, and tested the relationship between spirometric indices and anthropometric variables. The lower limit of normal for FEV1/FVC was calculated as the fifth percentile of the normal distribution for selected subjects. Results: While FEV1 and FVC decreased significantly with aging, the relationship between FEV1/FVC and age was not statistically significant in men or women. The lower limit of normal for FEV1/FVC was 0.65 in men and 0.67 in women. Fifty-five participants (15%) had FEV1/FVC < 0.70 and would have been inappropriately classified as obstructed according to the Global Initiative for Obstructive Lung Disease, American Thoracic Society/European Respiratory Society, and Canadian guidelines on chronic obstructive pulmonary disease. By applying different FEV1/FVC thresholds for the different age groups, as previously proposed in the literature, (0.70 for <70 years, 0.65 for 70¨C80 years, and 0.60 for >80 years) the percentage of patients classified as obstructed decreased to 6%. No subjects older than 80 years had an FEV1/FVC < 0.60. Conclusion: The present results confirm the inadequacy of FEV1/FVC < 0.70 as a diagnostic criterion for airway obstruction after the age of 65 years. FEV1/FVC < 0.65 and <0.67 (for men and women, respectively) could identify subjects with airway obstruction in such a population. Further reduction of the threshold after 80 years is not justified.
%K aging
%K airflow obstruction
%K chronic obstructive pulmonary disease
%K forced expiratory volume
%K lung function tests
%K spirometry A Letter to the Editor has been received and published for this article.
%U https://www.dovepress.com/diagnosis-of-airway-obstruction-in-the-elderly-contribution-of-the-sar-peer-reviewed-article-COPD