@article {1428, title = {Prevalence and correlates of respiratory symptoms and disease in the elderly. Cardiovascular Health Study.}, journal = {Chest}, volume = {106}, year = {1994}, month = {1994 Sep}, pages = {827-34}, abstract = {

Spirometry was performed by 5,201 elderly participants of the Cardiovascular Health Study during their baseline examination and a subset of the ATS/DLD-78 respiratory questionnaire was administered by trained interviewers. In never smokers (46 percent of the cohort), the overall prevalence of chronic cough was 9 percent, chronic phlegm was 13 percent, attacks of wheezing with dyspnea were 8 percent, and grade 3 dyspnea on exertion was 10 percent. The prevalence of lung disease in current smokers (12 percent of the cohort) was 8/7 percent (men/women) with chronic bronchitis and 14/5 percent with emphysema. Overall, 6 percent reported asthma (a physician-confirmed history) and 12 percent reported hay fever. Using a logistic regression model, attacks of wheezing with dyspnea were strongly associated with a lower FEV1, coronary heart disease, heart failure, and a large waist size (in participants without a diagnosis of asthma, chronic bronchitis, or emphysema). Undiagnosed airways obstruction was twice as likely in women and those with lower income, and was associated with current and former smoking, pack-years of smoking, and chronic cough. Dyspnea on exertion (DOE) was three times or more likely if a participant reported heart failure, coronary heart disease, or emphysema; and much more likely if their FEV1 or FVC was substantially reduced. Dyspnea on exertion was also positively associated with older age, chronic bronchitis or asthma, a larger waist or hip size, pack-years of smoking, and less education. We conclude that DOE and attacks of wheezing with dyspnea are commonly associated with cardiovascular disease and a low FEV1 in those over 65 years and that airways obstruction frequently remains undiagnosed in the elderly.

}, keywords = {Aged, Aged, 80 and over, California, Cohort Studies, Female, Humans, Lung Diseases, Male, Maryland, Multivariate Analysis, North Carolina, Pennsylvania, Prevalence, Prognosis, Respiratory Tract Diseases, Spirometry, Surveys and Questionnaires}, issn = {0012-3692}, author = {Enright, P L and Kronmal, R A and Higgins, M W and Schenker, M B and Haponik, E F} } @article {1376, title = {The association between waist circumference and risk of mortality considering body mass index in 65- to 74-year-olds: a meta-analysis of 29 cohorts involving more than 58 000 elderly persons.}, journal = {Int J Epidemiol}, volume = {41}, year = {2012}, month = {2012 Jun}, pages = {805-17}, abstract = {

BACKGROUND: For the elderly, the association between waist circumference (WC) and mortality considering body mass index (BMI) remains unclear, and thereby also the evidence base for using these anthropometric measures in clinical practice. This meta-analysis examined the association between WC categories and (cause-specific) mortality within BMI categories. Furthermore, the association of continuous WC with lowest and increased mortality risks was examined.

METHODS: Age- and smoking-adjusted relative risks (RRs) of mortality associated with WC-BMI categories and continuous WC (including WC and WC(2)) were calculated by the investigators and pooled by means of random-effects models.

RESULTS: During a 5-year-follow-up of 32 678 men and 25 931 women, we ascertained 3318 and 1480 deaths, respectively. A large WC (men: >=102 cm, women: >=88 cm) was associated with increased all-cause mortality RRs for those in the {\textquoteright}healthy{\textquoteright} weight {1.7 [95\% confidence interval (CI): 1.2-2.2], 1.7 (95\% CI: 1.3-2.3)}, overweight [1.1(95\% CI: 1.0-1.3), 1.4 (95\%: 1.1-1.7)] and obese [1.1 (95\% CI: 1.0-1.3), 1.6 (95\% CI: 1.3-1.9)] BMI category compared with the {\textquoteright}healthy{\textquoteright} weight (20-24.9 kg/m(2)) and a small WC (<94 cm, men; <80 cm, women) category. Underweight was associated with highest all-cause mortality RRs in men [2.2 (95\% CI: 1.8-2.8)] and women [2.3 (95\% CI: 1.8-3.1]. We found a J-shaped association for continuous WC with all-cause, cardiovascular (CVD) and cancer, and a U-shaped association with respiratory disease mortality (P < 0.05). An all-cause (CVD) mortality RR of 2.0 was associated with a WC of 132 cm (123 cm) in men and 116 cm (105 cm) in women.

CONCLUSIONS: Our results showed increased mortality risks for elderly people with an increased WC-even across BMI categories- and for those who were classified as {\textquoteright}underweight{\textquoteright} using BMI. The results provide a solid basis for re-evaluation of WC cut-points in ageing populations.

}, keywords = {Aged, Body Mass Index, Body Weight, Cardiovascular Diseases, Female, Humans, Male, Mortality, Neoplasms, Overweight, Respiratory Tract Diseases, Risk Assessment, Waist Circumference}, issn = {1464-3685}, doi = {10.1093/ije/dys008}, author = {de Hollander, Ellen L and Bemelmans, Wanda Je and Boshuizen, Hendriek C and Friedrich, Nele and Wallaschofski, Henri and Guallar-Castill{\'o}n, Pilar and Walter, Stefan and Zillikens, M Carola and Rosengren, Annika and Lissner, Lauren and Bassett, Julie K and Giles, Graham G and Orsini, Nicola and Heim, Noor and Visser, Marjolein and de Groot, Lisette Cpgm} }