03006nas a2200373 4500008004100000022001400041245007500055210006900130260001300199300001200212490000700224520199400231653000902225653002202234653002802256653001202284653001102296653001802307653002502325653001102350653002002361653000902381653001902390653002302409653001502432653002602447653001502473653001802488100002702506700001702533700002302550700002302573856003602596 2015 eng d a1532-541500aLower Extremity Proximal Muscle Function and Dyspnea in Older Persons.0 aLower Extremity Proximal Muscle Function and Dyspnea in Older Pe c2015 Aug a1628-330 v633 a

OBJECTIVES: To evaluate the association between performance on a single chair stand and moderate to severe exertional dyspnea.

DESIGN: Cross-sectional.

SETTING: Cardiovascular Health Study.

PARTICIPANTS: Community-dwelling individuals aged 65 and older (N = 4,413; mean age 72.6; female, n = 2,518 (57.1%); nonwhite, n = 199 (4.5%); obese, n = 788 (17.9%); history of smoking, n = 2,410 (54.6%)).

MEASUREMENTS: Performance on single chair stand (poor (unable to rise without arm use) vs normal (able to rise without arm use)), moderate to severe exertional dyspnea (American Thoracic Society grade ≥2), age, sex, ethnicity, obesity, smoking, frailty status (Fried-defined nonfrail, prefrail, frail), high cardiopulmonary risk (composite of cardiopulmonary diseases and diabetes mellitus), spirometric impairment, arthritis, depression, stroke, and kidney disease.

RESULTS: Poor performance on the single chair stand was established in 369 (8.4%) and moderate to severe exertional dyspnea in 773 (17.5%). Prefrail status was established in 2,210 (50.1%), frail status in 360 (8.2%), arthritis in 2,241 (51.4%), high cardiopulmonary risk in 2,469 (55.9%), spirometric impairment in 1,076 (24.4%), kidney disease in 111 (2.5%), depression in 107 (2.4%), and stroke in 93 (2.1%). In multivariable regression models, poor performance on the single chair stand was associated with moderate to severe exertional dyspnea (unadjusted odds ratio (OR) = 3.48, 95% confidence interval (CI) = 2.78-4.36; adjusted OR = 1.85, 95% CI = 1.41-2.41).

CONCLUSION: Poor performance on a single chair stand was associated with an adjusted 85% greater likelihood of moderate to severe exertional dyspnea than normal performance. These results suggest that reduced proximal muscle function of the lower extremities is associated with moderate to severe exertional dyspnea, even after adjusting for multiple confounders.

10aAged10aAged, 80 and over10aCross-Sectional Studies10aDyspnea10aFemale10aFrail Elderly10aGeriatric Assessment10aHumans10aLower Extremity10aMale10aMotor Activity10aMuscle Contraction10aPrevalence10aRetrospective Studies10aSpirometry10aUnited States1 aFragoso, Carlos, A Vaz1 aAraujo, Katy1 aLeo-Summers, Linda1 aVan Ness, Peter, H uhttps://chs-nhlbi.org/node/6821