Health Sciences North Research Institute, Sudbury, ON, Canada; Department of Health Research Methods, Evidence and Impact, McMaster University, ON, Canada.
Department of Medicine, McMaster University, Hamilton, ON, Canada.
Respir Med. 2020 Nov;173:106157. doi: 10.1016/j.rmed.2020.106157. Epub 2020 Sep 23.
Maintenance of lung function is an often underappreciated, yet critical component of healthy aging. Given the unprecedented shift in the average age of Canadians over the next half century, it will be important to investigate the determinants of lung function in the elderly. In the following study, we estimated the association between lung function and a broad array of factors related to sociodemographics, lifestyle, chronic medical conditions and psychosocial factors in older adults aged 45-86 years old using cross-sectional data from the Canadian Longitudinal Study of Aging (n = 21,338). In addition to examining the entire cohort, we also performed stratified analyses within men/women, adults aged 45-64/65+, and healthy/comorbid. In multivariable regression, our explanatory factors (excluding age, sex, height and ethnicity) were able to explain 17% and 11% of the total variance in FEV and FEV/FVC, respectively. Notable and significant contributions were observed for respiratory disease, smoking, obesity, income, and physical activity, while psychosocial factors mainly exhibited non-significant associations. Generally, these associations were stronger for males than females, and adults 65 and older as compared to those aged 45-64. Our findings indicate that there are pervasive and generally under-recognized sociodemographic and lifestyle factors that exhibit significant associations with FEV and FEV/FVC in older adults. While implication of causality in these relationships is not possible due to the cross-sectional nature of the study, future work aiming to investigate determinants of lung health in older adults may choose to target these factors, given that many are modifiable.
维护肺功能是健康老龄化中一个经常被低估但至关重要的组成部分。考虑到未来半个世纪加拿大人口平均年龄的空前变化，研究老年人肺功能的决定因素将非常重要。在以下研究中，我们使用加拿大老龄化纵向研究（Canadian Longitudinal Study of Aging）的横断面数据，估计了肺功能与 45-86 岁老年人中与社会人口统计学、生活方式、慢性疾病和心理社会因素相关的广泛因素之间的关联（n=21338）。除了检查整个队列外，我们还在男性/女性、45-64/65+岁成年人和健康/合并症成年人中进行了分层分析。在多变量回归中，我们的解释因素（不包括年龄、性别、身高和种族）能够分别解释 FEV 和 FEV/FVC 总方差的 17%和 11%。观察到呼吸疾病、吸烟、肥胖、收入和体力活动有显著和重要的贡献，而心理社会因素主要表现出非显著关联。一般来说，这些关联在男性中比女性更强，在 65 岁及以上的成年人中比 45-64 岁的成年人更强。我们的研究结果表明，存在普遍存在且普遍未被认识到的社会人口统计学和生活方式因素，这些因素与老年人的 FEV 和 FEV/FVC 显著相关。由于研究的横断面性质，这些关系中因果关系的含义是不可能的，但未来旨在研究老年人肺部健康决定因素的工作可能会选择针对这些因素，因为许多因素是可以改变的。
