Author(s): Gaspar-Marques, João ; Palmeiro, Teresa ; Caires, Iolanda ; Leiria Pinto, Paula ; Neuparth, Nuno ; Carreiro Martins, Pedro
Date: 2021
Persistent ID: http://hdl.handle.net/10362/120530
Origin: Repositório Institucional da UNL
Subject(s): Aged; comorbidity; lung diseases; obstructive; respiratory disorders; SDG 3 - Good Health and Well-being
Funding: The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This study was supported by AstraZeneca – Projecto OLDER (CEDOC/2015/59) and Finnee Project (PTDC/CCI-BIO/29702/2017).
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.
