NOVA Medical School/Comprehensive Health Research Centre (CHRC), Lisbon, Portugal.
Immunoallergology Service, Dona Estefânia Hospital, Central Lisbon Hospital Centre, EPE, Lisbon, Portugal.
Sci Prog. 2021 Apr-Jun;104(2):368504211013171. doi: 10.1177/00368504211013171.
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 FEV/FVC<-1.64) and a restrictive spirometry pattern (z-score FEV/FVC ≥ +1.64 and z-score FVC<-1.64). Seventy-two percent of the individuals who took part in the study ( = 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.
尽管将慢性呼吸道疾病的分类方法转变为可治疗特征（TT）方法，但针对非常高龄患者的数据仍然缺乏。本研究的目的是评估非常高龄患者 TT 的频率，并研究肺外 TT 与通气缺陷之间的关系。居住在养老院的个体（≥75 岁）回答了一份标准化问卷，进行了肺量测定、过敏和呼出的一氧化氮分数评估，并测量了血压和外周脉搏血氧饱和度。评估了肺、肺外和行为 TT。主要结局变量为气流受限（支气管扩张剂后 FEV/FVC z 分数<-1.64）和限制性肺量测定模式（FEV/FVC z 分数≥+1.64 和 FVC z 分数<-1.64）。参与研究的个体中，72%（n=234）为女性，参与者的中位年龄为 86（IQR：7.4）岁。至少有一个肺 TT 见于 105 名（44.9%）个体。最常见的肺外 TT 为：持续性全身炎症（47.0%）、贫血（34.4%）、抑郁（32.5%）和肥胖（27.4%）。气流受限仅与吸烟有关（OR 5.03；95% CI 1.56-16.22）。限制性肺量测定模式与认知障碍有关（OR：3.89；95% CI：1.55-9.79）。存在各种 TT 的高频率。限制性肺量测定模式与认知障碍之间的新关联突出了对这一年龄组进行临床研究的紧迫性。
