%0 Journal Article %J COPD %D 2013 %T Effects of respiratory and non-respiratory factors on disability among older adults with airway obstruction: the Cardiovascular Health Study. %A Locke, Emily %A Thielke, Stephen %A Diehr, Paula %A Wilsdon, Anthony G %A Barr, R Graham %A Hansel, Nadia %A Kapur, Vishesh K %A Krishnan, Jerry %A Enright, Paul %A Heckbert, Susan R %A Kronmal, Richard A %A Fan, Vincent S %K Activities of Daily Living %K Aged %K Cognition Disorders %K Cohort Studies %K Comorbidity %K Depression %K Diabetes Mellitus %K Disease Progression %K Dyspnea %K Female %K Heart Failure %K Humans %K Linear Models %K Longitudinal Studies %K Male %K Muscle Weakness %K Myocardial Ischemia %K Osteoporosis %K Pulmonary Disease, Chronic Obstructive %K Severity of Illness Index %K Spirometry %X

BACKGROUND: High rates of disability associated with chronic airway obstruction may be caused by impaired pulmonary function, pulmonary symptoms, other chronic diseases, or systemic inflammation.

METHODS: We analyzed data from the Cardiovascular Health Study, a longitudinal cohort of 5888 older adults. Categories of lung function (normal; restricted; borderline, mild-moderate, and severe obstruction) were delineated by baseline spirometry (without bronchodilator). Disability-free years were calculated as total years alive and without self-report of difficulty performing &γτ;1 Instrumental Activities of Daily Living over 6 years of follow-up. Using linear regression, we compared disability-free years by lung disease category, adjusting for demographic factors, body mass index, smoking, cognition, and other chronic co-morbidities. Among participants with airflow obstruction, we examined the association of respiratory factors (FEV1 and dyspnea) and non-respiratory factors (ischemic heart disease, congestive heart failure, diabetes, muscle weakness, osteoporosis, depression and cognitive impairment) on disability-free years.

RESULTS: The average disability free years were 4.0 out of a possible 6 years. Severe obstruction was associated with 1 fewer disability-free year compared to normal spirometry in the adjusted model. For the 1,048 participants with airway obstruction, both respiratory factors (FEV1 and dyspnea) and non-respiratory factors (heart disease, coronary artery disease, diabetes, depression, osteoporosis, cognitive function, and weakness) were associated with decreased disability-free years.

CONCLUSIONS: Severe obstruction is associated with greater disability compared to patients with normal spirometery. Both respiratory and non-respiratory factors contribute to disability in older adults with abnormal spirometry.

%B COPD %V 10 %P 588-96 %8 2013 Oct %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/23819728?dopt=Abstract %R 10.3109/15412555.2013.781148