scholarly journals Pulmonary and Physical Function Limitations in Aging Men with and without HIV from the Multicenter AIDS Cohort Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 612-612
Author(s):  
Mona Abdo ◽  
Ken Kunisaki ◽  
Valentina Stosor ◽  
Gypsyamber D'Souza ◽  
Madiha Abdel-Maksoud ◽  
...  

Abstract We sought to determine effects of age, HIV serostatus, and smoking on the associations between pulmonary function and physical function impairments using Multicenter AIDS Cohort Study data. Associations between physical function outcomes gait speed (m/sec) and grip strength (kg) with normalized pulmonary function tests (diffusion capacity for carbon monoxide (DLCO, n=1,048) and forced expiratory volume in one second (FEV1, n=1,029)) were examined. Adjusted mixed-effects models included interaction terms to assess effect modification. 574(55%) were HIV+, with median age 57(IQR=48,64) and mean cumulative smoking pack-years 12.2(SD=19.0). 349(33%) had impaired DLCO (<80% of predicted) and 130(13%) had impaired FEV1 (<80% of predicted). Participants with impaired DLCO had weaker grip strength than those with normal DLCO (estimate= -3.5[95% CI=-4.6,-2.4]kg; p<0.001). Participants with impaired DLCO had slower gait speed than those with normal DLCO (estimate= -0.04[95% CI= -0.06,-0.02]m/sec; p=0.002). Age modified the DLCO effect on gait (p-interaction=0.01) but not grip (p-interaction=0.09). The association between decreased DLCO and slower gait was more pronounced in older participants. Smoking or HIV serostatus did not significantly modify the DLCO effect on gait (all p-interaction≥0.14) or grip (p-interaction=0.74, p-interaction=0.058, respectively). As with DLCO, participants with impaired FEV1 had weaker grip strength (estimate=-3.0[95% CI= -4.7,-1.3]kg; p<0.001) than those with normal FEV1. FEV1 was not associated with gait speed(p=0.98). Age, HIV serostatus or smoking did not modify the associations between FEV1 and gait speed or grip strength (all p-interaction>0.05). Associations between lower DLCO/FEV1 and decreased physical function suggest that interventions to improve pulmonary function may also preserve physical function with aging.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Takumi Noda ◽  
Kentaro Kamiya ◽  
Nobuaki Hamazaki ◽  
Kohei Nozaki ◽  
Takafumi Ichikawa ◽  
...  

AbstractAlthough heart failure (HF) and liver dysfunction often coexist because of complex cardiohepatic interactions, the association between liver dysfunction and physical dysfunction, and between coexistence of both and prognosis in HF patients remains unclear. We reviewed 895 patients with HF (mean age, 69.4 ± 14.2 years) who underwent liver function test using model for end-stage liver disease excluding international normalized ratio (MELD-XI) score and physical function test (grip strength, leg strength, gait speed, and 6-min walking distance [6MWD]). In the multiple regression analysis, MELD-XI score was independently associated with lower grip strength, leg strength, gait speed, and 6MWD (all P < 0.001). One hundred thirty deaths occurred over a median follow-up period of 1.67 years (interquartile range: 0.62–3.04). For all-cause mortality, patients with high MELD-XI scores and reduced physical functions were found to have a significantly higher mortality risk even after adjusting for several covariates (grip strength, hazard ratio [HR]: 3.80, P < 0.001; leg strength, HR: 4.65, P < 0.001; gait speed, HR: 2.49, P = 0.001, and 6MWD, HR: 5.48, P < 0.001). Liver dysfunction was correlated with reduced physical function. Moreover, the coexistence of lower physical function and liver dysfunction considerably affected prognosis in patients with HF.


2021 ◽  
Vol 10 (7) ◽  
pp. 1535
Author(s):  
Ji-Sun Kim ◽  
Jun-Ook Park ◽  
Dong-Hyun Lee ◽  
Ki-Hong Chang ◽  
Byung Guk Kim

Objectives: To identify the relationship between pulmonary function and subjective olfactory dysfunction in middle-aged and older adults. Materials and Methods: We used Korea National Health and Nutrition Examination Survey data from 2010 to 2012 to analyze 6191 participants in their 50s or older. Results: The frequency of olfactory dysfunction was 6.8% among the subjects with normal pulmonary function tests, but was significantly more frequent in those diagnosed with restrictive (9.6%) or obstructive (10.1%) pulmonary function. Forced volume vital capacity, forced expiratory volume (FEV)1, FEV6, and peak expiratory flow were significantly lower in the olfactory dysfunction group. The risk of olfactory dysfunction was significantly associated with obstructive pulmonary function (odds ratio (OR) [95% confidence interval (CI)]: 1.449 [1.010–2.081]) after adjusting for confounders (sex, rhinitis, chronic rhinosinusitis, hypertension, dyslipidemia, education level, stress, depressed mood, and suicidal ideation). Conclusion: Middle-aged and older adults with obstructive pulmonary function had a higher incidence of subjective olfactory dysfunction than the normal pulmonary function group. Early olfactory testing may improve the quality of life of patients with obstructive pulmonary function.


2016 ◽  
Vol Volume 11 ◽  
pp. 2527-2534 ◽  
Author(s):  
Viktor Johansson Strandkvist ◽  
Helena Backman ◽  
Jenny Roding ◽  
Caroline Stridsman ◽  
Anne Lindberg

2021 ◽  
Vol 9 ◽  
Author(s):  
Xiuhua Yu ◽  
Jiaoyang Wei ◽  
Yanchun Li ◽  
Lu Zhang ◽  
Hongming Che ◽  
...  

Backgroud: Postinfectious bronchiolitis obliterans (PIBO) is a rare respiratory disease. In recent years, the disease has been recognized and diagnosed increasingly in children. Pulmonary function is important for diagnosis, identifying the severity of the PIBO and monitoring progression. But there have been only a few studies that followed the evolution of PIBO on the basis of pulmonary function tests (PFTs).Objective: The study targeted the evolution of pulmonary function and bronchodilator response in a case series of Chinese children with PIBO.Methods: Twelve children between the ages of 6–99 months with PIBO were studied retrospectively from 2009 to 2019. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), the FEV1/FVC ratio, and maximal midexpiratory flow velocity 25–75% (MMEF25−75%) were collected at each PFT, and bronchodilator responses were evaluated. Spirometric parameters were monitored over time, and generalized linear mixed models were used to analyze longitudinal panel data.Results: The median baseline PFT values for FVC, FEV1, the FEV1/FVC ratio, and MMEF25−75% were 41.6, 39.75, 90.7, and 22.2%, respectively. At the initial PFTs, 10 (83.3%) patients demonstrated a significant bronchodilator response. FVC and FEV1 increased by 8.212%/year and 5.007%/year, respectively, and the FEV1/FVC ratio decreased by an average of 3.537%/year. MMEF25−75% showed improvement at an average rate of 1.583% every year. Overall, FEV1 and MMEF25−75% showed different degrees of improvement after the use of inhaled bronchodilators at each PFT session for 10 patients, and FEV1 measures demonstrated significant (&gt;12%) β2-bronchodilation in 56% of PFT sessions.Conclusions: Pediatric patients with PIBO showed an obstructive defect in pulmonary function. The FVC, FEV1, and MMEF25−75% improved as they grew older, while the FEV1/FVC ratio decreased. This may be due to the development of lung parenchyma more than airway growth. Airway obstruction in some patients improved with the use of β2 agonists.


Rheumatology ◽  
2019 ◽  
Vol 59 (8) ◽  
pp. 2024-2029 ◽  
Author(s):  
Yukai Wang ◽  
Shaoqi Chen ◽  
Jianqun Lin ◽  
Xuezhen Xie ◽  
Shijian Hu ◽  
...  

Abstract Objective Idiopathic inflammatory myositis-associated interstitial lung disease (IIM-ILD) significantly increases morbidity and mortality. Lung ultrasound B-lines and Krebs von den Lungen-6 (KL-6) are identified as new sonographic and serum markers of ILD, respectively. The aim of our work was to assess the role of B-lines and KL-6 as markers of the severity of IIM-ILD. For this purpose, the correlation among B-lines score, serum KL-6 levels, high-resolution CT (HRCT) score, and pulmonary function tests were investigated in IIM-ILD patients. Methods Thirty-eight patients with IIM-ILD underwent chest HRCT scans, lung ultrasound and pulmonary function tests (independently performed within 1 week) examination. To assess severity and extent of ILD at HRCT, the Warrick score was used. The B-lines score denoting the extension of ILD was calculated by summing the number of B-lines on a total of 50 scanning sites. Serum KL-6 levels (U/ml) was measured by chemiluminescent enzyme immunoassay. Results A significant correlation was found between the B-lines score and serum KL-6 levels (r = 0.43, P &lt; 0.01), and between the Warrick score and serum KL-6 levels (r = 0.45, P &lt; 0.01). A positive correlation between B-lines score and the Warrick score (r = 0.87, P &lt; 0.0001) was also confirmed. Both B-lines score and KL-6 levels inversely correlated to diffusion capacity for carbon monoxide (r = −0.77, P &lt; 0.0001 and r = −0.42, P &lt; 0.05, respectively) and total lung capacity (r = −0.73, P &lt; 0.0001 and r = −0.36, P &lt; 0.05, respectively). Moreover, B-lines correlated inversely with forced vital capacity (r = −0.73, P &lt; 0.0001), forced expiratory volume in 1 s (r = −0.69, P &lt; 0.0001). Conclusion B-lines score and serum KL-6 levels correlate with HRCT findings and pulmonary function tests, supporting their use as measures of IIM-ILD severity.


2020 ◽  
Vol 17 ◽  
pp. 147997312096702
Author(s):  
David Lang ◽  
Kaveh Akbari ◽  
Stefan Walcherberger ◽  
Benedikt Hergan ◽  
Andreas Horner ◽  
...  

The aim was to evaluate the impact of multiple high-resolution computed tomography (HRCT) features on pulmonary function test (PFT) biomarkers in fibrotic interstitial lung disease (FILD) patients. HRCT of subsequently ILD-board-discussed FILD patients were semi-quantitatively evaluated in a standardized approach: 18 distinct lung regions were scored for noduli, reticulation, honeycombing, consolidations, ground glass opacities (GGO), traction bronchiectasis (BRK) and emphysema. Total lung capacity (TLC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC, diffusion capacity for carbon monoxide (DLCO) and transfer coefficient (KCO) were assessed. Interactions between each PFT biomarker and all HRCT scores were visualized by network analyses, modeled according to the Schwarz Bayesian Information Criterion and incorporated in uni- and multivariate stepwise regression analyses. Among 108 FILD patients (mean age 67 years, 77% male), BRK extent was a major significant uni- or multivariate determinant of all PFT analyzed. Besides that, diffusion-based variables DLCO and KCO showed a larger dependency on reticulation, emphysema and GGO, while forced expiratory volume-based measures FEV1, FVC and FEV1/FVC were more closely associated with consolidations. For TLC, the only significant multivariate determinant was reticulation. In conclusion, PFT biomarkers derived from spirometry, body plethysmography and diffusion capacity in FILD patients are differentially influenced by semi-quantified HRCT findings.


2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Toshiki Kutsuna ◽  
Yusuke Isobe ◽  
Takaaki Watanabe ◽  
Yusuke Matsunaga ◽  
Satomi Kusaka ◽  
...  

Abstract Background Elderly adults undergoing hemodialysis (HD) have multiple comorbidities, physical frailty, and functional dependence with activities of daily living (ADL). ADL difficulty is an early predictor of ADL dependency in community-dwelling elderly adults. However, the characteristics of ADL difficulty in patients undergoing HD have not yet been reported. The present study aimed to examine the current status and characteristics of physical function and ADL difficulty in ambulatory elderly patients undergoing HD. Methods In all, 136 elderly outpatients undergoing HD and 40 community-dwelling controls participated in the present study. The characteristics, physical function (SARC-F score, grip strength, five-times sit-to-stand test time, usual gait speed, maximum gait speed, and short physical performance battery score), and scores from the ADL difficulty questionnaires [difficulty related to upper limb (U/L) and lower limb (L/L) functions] were compared between the HD and control groups. Multiple regression analysis was performed to examine whether the characteristics of physical function were able to discriminate ADL difficulty in the HD group. Results The HD group had a significantly greater SARC-F score, lower grip strength, longer five-times sit-to-stand test time, slower usual gait speed, slower maximum gait speed, lower short physical performance battery score, and lower U/L and L/L ADL difficulty scores compared to the control group (all P < 0.001). The distribution of U/L and L/L ADL difficulty scores showed a wider variation in the HD group than in the control group. The U/L ADL difficulty score was independently associated with the SARC-F score (β = −0.52, P < 0.001) and grip strength (β = 0.21, P = 0.02). The L/L ADL difficulty score was independently associated with the SARC-F score (β = −0.56, P < 0.001) and usual gait speed (β = 0.35, P < 0.001). Conclusions The elderly HD group had a poorer physical function and experienced stronger ADL difficulty than the control group. There was an association between ADL difficulty and sarcopenia or poor physical function among patients undergoing HD. These findings provide useful data for effective clinical management to prevent decline of ADL in ambulatory elderly patients undergoing HD.


1995 ◽  
Vol 2 (4) ◽  
pp. 231-235
Author(s):  
JL Wright ◽  
J-P Sun ◽  
S Vedal ◽  
A Churg

OBJECTIVE: To compare the effects of a brief low level exposure to cigarette smoke in rats with known low (Sprague-Dawley) and high (Fisher) airway responsiveness, to test the hypothesis that airways reactivity influences the severity or duration of pulmonary function alterations after cigarette smoke exposure.METHODS: Baseline pulmonary function tests and methacholine dose response tests were conducted in 10 Sprague-Dawley and 10 Fisher rats. On the following day, the animals were reanaesthetized, and breathed for 1 min from a 2 L chamber into which 25 mL of fresh cigarette smoke had been injected, followed by a second set of pulmonary function and methacholine response tests; a final set was performed two weeks later.RESULTS: Sprague-Dawley rats were larger, with larger lung volumes, compliance and flow rates, but Fisher rats showed a fourfold higher airway reactivity. Although neither resistance nor response to methacholine changed in either strain of animal, Sprague-Dawley rats showed an increase in residual volume post smoke, which was not sustained over two weeks, and sustained small increases in vital capacity, total lung capacity and static lung compliance, with a sustained decrease in forced expiratory volume in 0.1 s, while Fisher rats showed only a small sustained increase in functional residual capacity.CONCLUSIONS: Although there are marked differences in pulmonary function between the two different strains of rats, increased airways responsiveness per se does not make the animal more sensitive to the acute effects of cigarette smoke, and the effects of cigarette smoke on pulmonary function are not necessarily related to increased airway resistance. Pulmonary function alterations seen after brief cigarette smoke exposure may be sustained for a relatively long period of time.


2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Amy E. Mendham ◽  
Naomi E. Brooks ◽  
Lisa K. Micklesfield ◽  
Mieke Faber ◽  
Dirk L. Christensen ◽  
...  

AbstractIntroductionSouth Africa (SA) is a developing country with an ageing population. Adequate nutrition and physical activity (PA) protect against the loss of muscle mass and physical function, both of which are important components of sarcopenia. This study aimed to measure the prevalence of sarcopenia in older black SA women and investigate its associations with PA and protein intake.Materials and MethodsOlder black SA women (age, 68 (range; 60–85 years) n = 122) completed sociodemographic questionnaires, 24 h urine collection (estimate protein intake), venous blood (hs-C-reactive protein (hs-CRP) and ferritin), functional tests (grip strength, 3 m timed-up-and-go (TUG), 10 m walk test) and PA monitoring (activPAL). Dual-energy x-ray absorptiometry whole-body scans assessed fat and fat-free soft tissue mass (FFSTM).ResultsAccording to the European Working group on Sarcopenia in Older People (EWGSOP)2, 2.5% (n = 3) had confirmed sarcopenia of a low severity based on normal physical function. Of the total cohort, 9% (n = 11) had low grip strength, 22.1% (n = 27) had a low appendicular skeletal muscle index (ASMI), and no women had low TUG (s) or gait speed (m/s). Higher ASMI was associated with lower hs-CRP (p = 0.05; Rho = -0.209) and higher ferritin (Rho = 0.252; p = 0.019), grip strength (kg, Rho = 0.223; p = 0.015), and gait speed (m/s, Rho = 0.180; p = 0.050). Protein intake suggested intake of 41.8g/day/ or 0.51 g/kg of body mass/day. Higher total protein intake (g/24h), was associated with higher FFSTM (kg) and ASMI (p < 0.001). PA outcomes were not correlated with FFSTM or ASMI (p > 0.05), however, there was a strong positive correlation of TUG (s) and gait speed (m/s) with time spent: 1) stepping per day (min) and; 2) at a high cadence (> 100 steps/min) (all p < 0.01). Daily step count was 7137 ± 3233 (mean ± Standard deviation), with 97.9 ± 38.7 min of total time spent stepping and 12.6 ± 16.8 min spent stepping at a high cadence (> 100 steps/min). Of note, 13.9% (n = 17) of women were completing > 10,000 steps/day.DiscussionBased on the EWGSOP2 criteria, there is a low prevalence of sarcopenia in older black SA women, explained by the maintenance of strength and physical function that directly related to PA, especially that performed at higher intensities. In contrast, low muscle mass was relatively prevalent (22.1%) and was associated with low dietary protein and not PA. Notably, it may be important to review the cut-points of EWGSOP2 criteria to be specific to the older SA women from disadvantaged communities.


Sign in / Sign up

Export Citation Format

Share Document