Department of Medicine (DIMED), Geriatrics Division, University of Padova, Italy; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden.
Exp Gerontol. 2020 Jul 1;135:110941. doi: 10.1016/j.exger.2020.110941. Epub 2020 Mar 31.
Peak expiratory flow (PEF) and walking speed (WS) have been proposed as indicators of robustness and are independent predictors of health-related outcomes. We aimed to investigate how the co-occurrence of respiratory and physical impairments changes as a function of age, and to quantify the association of the combination of low PEF and slow WS on survival in older people.
This prospective study analyzes data from 2656 community-dwelling participants (age ≥ 60 years) from the SNAC-K study. At baseline, we assessed: (1) sociodemographic, lifestyle and medical data; (2) respiratory function, estimated through PEF and expressed as standardized residual (SR) percentile; and (3) WS at usual pace, categorized as no (>1.2 m/s), mild (0.8-1.2 m/s) and moderate-to-severe (<0.8 m/s) walking impairment. Participants' vital status over an 18-year follow-up was derived from registers. The association of different combinations of PEF and WS on median survival time was estimated through Laplace regression adjusted for potential confounders.
Respiratory and walking impairments co-occurred more frequently with increasing age. Among individuals with PEF SR-percentiles < 10th, the percentage of moderate-to-severe walking impairment was 12.1% in sexagenarians, 35.7% in septuagenarians, and 75-80% in the oldest old. The greatest reduction in median survival time (-5.4 [95%CI: -6.4; -4.4] years, p < 0.001) was observed among people with combined respiratory and moderate-to-severe walking impairments, compared with those with no dysfunctions, who had a median survival time of 17.4 (95%CI: 17.0; 17.8) years.
Impaired PEF and WS co-occur more frequently with advancing age, and their co-occurrence is associated with shorter survival.
呼气峰流速（PEF）和步行速度（WS）已被提出作为稳健性的指标，并且是健康相关结局的独立预测因子。我们旨在研究随着年龄的增长，呼吸和身体损伤的共存情况如何变化，并量化低 PEF 和慢 WS 组合对老年人生存的关联。
这项前瞻性研究分析了来自 SNAC-K 研究的 2656 名居住在社区的参与者（年龄≥60 岁）的数据。在基线时，我们评估了：（1）社会人口统计学、生活方式和医疗数据；（2）通过 PEF 评估的呼吸功能，并表示为标准化残差（SR）百分位数；（3）以正常速度的 WS，分为无（>1.2 m/s）、轻度（0.8-1.2 m/s）和中度至重度（<0.8 m/s）步行障碍。通过从登记处获得参与者在 18 年随访期间的生存状况。通过拉普拉斯回归调整潜在混杂因素，估计不同 PEF 和 WS 组合对中位生存时间的关联。
随着年龄的增长，呼吸和步行损伤的共存频率更高。在 PEF SR 百分位数<第 10 个的个体中，中度至重度步行障碍的百分比在 60 岁组为 12.1%，70 岁组为 35.7%，最年长组为 75-80%。与没有功能障碍的人相比，合并呼吸和中度至重度步行障碍的人中位生存时间（-5.4 [95%CI：-6.4；-4.4] 年，p<0.001）显著缩短，这些人中位生存时间为 17.4 岁（95%CI：17.0；17.8）。
PEF 和 WS 受损更频繁地与年龄增长相关，它们的共存与较短的生存时间相关。
