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Open AccessArticle

Cross-Sectional and Longitudinal Associations between Peak Expiratory Flow and Frailty in Older Adults

1
Department of Medicine (DIMED), Geriatrics Division, University of Padova, 35128 Padova, Italy
2
Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, 17177 Stockholm, Sweden
3
Stockholm Gerontology Research Center, 113 46 Stockholm, Sweden
4
National Research Council, Neuroscience Institute, 35128 Padova, Italy
5
Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 17177 Stockholm, Sweden
6
Allied Health Professionals, Function Area Occupational Therapy & Physiotherapy, Karolinska University Hospital, 14186 Stockholm, Sweden
7
Centro Medicina dell’Invecchiamento, IRCCS Fondazione Policlinico “A. Gemelli” and Catholic University of Rome, 00168 Rome, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(11), 1901; https://doi.org/10.3390/jcm8111901
Received: 4 October 2019 / Revised: 30 October 2019 / Accepted: 5 November 2019 / Published: 7 November 2019
Peak expiratory flow (PEF) has been linked to several health-related outcomes in older people, but its association with frailty is still unclear. This study investigates the association between PEF and prevalent and incident frailty in older adults. Data come from 2559 community-dwelling participants (age ≥ 60 years) of the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K). Baseline PEF was expressed as standardized residual (SR) percentiles. Frailty was assessed at baseline and over six years, according to the Fried criteria. Associations between PEF and frailty were estimated cross-sectionally through logistic regressions, and longitudinally by multinomial logistic regression, considering death as alternative outcome. Obstructive respiratory diseases and smoking habits were treated as potential effect modifiers. Our cross-sectional results showed that the 10th–49th and <10th PEF SR percentile categories were associated with three- and five-fold higher likelihood of being frail than the 80th–100th category. Similar estimates were confirmed longitudinally, i.e., adjusted OR = 3.11 (95% CI: 1.61–6.01) for PEF SR percentiles < 10th, compared with 80th–100th percentiles. Associations were enounced in participants without physical deficits, and tended to be stronger among those with baseline obstructive respiratory diseases, and, longitudinally, also among former/current smokers. These findings suggest that PEF is a marker of general robustness in older adults, and its reduction exceeding that expected by age is associated with frailty development. View Full-Text
Keywords: peak expiratory flow; frailty; obstructive respiratory diseases; longitudinal study peak expiratory flow; frailty; obstructive respiratory diseases; longitudinal study
MDPI and ACS Style

Trevisan, C.; Rizzuto, D.; Maggi, S.; Sergi, G.; Welmer, A.-K.; Vetrano, D.L. Cross-Sectional and Longitudinal Associations between Peak Expiratory Flow and Frailty in Older Adults. J. Clin. Med. 2019, 8, 1901.

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