Respiratory impairment and dyspnea and their associations with physical inactivity and mobility in sedentary community-dwelling older persons

J Am Geriatr Soc. 2014 Apr;62(4):622-8. doi: 10.1111/jgs.12738. Epub 2014 Mar 17.

Abstract

Objectives: To evaluate the prevalence of respiratory impairment and dyspnea and their associations with objectively measured physical inactivity and performance-based mobility in sedentary older persons.

Design: Cross-sectional.

Setting: Lifestyle Interventions and Independence for Elders Study.

Participants: Community-dwelling older persons (n = 1,635, mean age 78.9) who reported being sedentary (<20 min/wk of regular physical activity and <125 min/wk of moderate physical activity in past month).

Measurements: Respiratory impairment was defined as low ventilatory capacity (forced expiratory volume in 1 second less than lower limit of normal (LLN)) and respiratory muscle weakness (maximal inspiratory pressure <LLN). Dyspnea was defined as moderate to severe ratings on the modified Borg index, immediately after a 400-m walk test (400-MWT). Physical inactivity was defined according to high sedentary time as the highest quartile of participants with accelerometry-measured activity of <100 counts/min. Performance-based mobility was evaluated using the Short Physical Performance Battery (≤ 7 defined as moderate to severe mobility impairment) and 400-MWT gait speed (<0.8 m/s defined as slow).

Results: Prevalence rates were 17.7% for low ventilatory capacity, 14.7% for respiratory muscle weakness, 31.6% for dyspnea, 44.7% for moderate to severe mobility impairment and 43.6% for slow gait speed. Significant associations were found between low ventilatory capacity and slow gait speed (adjusted odds ratio (aOR) = 1.41, 95% confidence interval (CI) = 1.03-1.92), between respiratory muscle weakness and moderate to severe mobility impairment (aOR = 1.42, 95% CI = 1.03-1.95), and between dyspnea and high sedentary time (aOR = 1.98, 95% CI = 1.28-3.06) and slow gait speed (aOR = 1.70, 95% CI = 1.22-2.38).

Conclusion: Respiratory impairment and dyspnea are prevalent in sedentary older persons and are associated with objectively measured physical inactivity and poor performance-based mobility. Because they are modifiable, respiratory impairment and dyspnea should be considered in the evaluation of sedentary older persons.

Trial registration: ClinicalTrials.gov NCT01072500.

Keywords: FEV1; dyspnea; mobility; respiratory muscle weakness; sedentary.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Dyspnea / epidemiology
  • Dyspnea / physiopathology
  • Dyspnea / rehabilitation*
  • Exercise Therapy / methods*
  • Female
  • Follow-Up Studies
  • Forced Expiratory Volume / physiology
  • Geriatric Assessment*
  • Humans
  • Life Style*
  • Male
  • Mobility Limitation*
  • Patient Education as Topic
  • Prevalence
  • Respiratory Insufficiency / epidemiology
  • Respiratory Insufficiency / physiopathology
  • Respiratory Insufficiency / rehabilitation*
  • Walking / physiology*

Associated data

  • ClinicalTrials.gov/NCT01072500