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Lower Extremity Proximal Muscle Function and Dyspnea in Older Persons.

TitleLower Extremity Proximal Muscle Function and Dyspnea in Older Persons.
Publication TypeJournal Article
Year of Publication2015
AuthorsFragoso, CAVaz, Araujo, K, Leo-Summers, L, Van Ness, PH
JournalJ Am Geriatr Soc
Volume63
Issue8
Pagination1628-33
Date Published2015 Aug
ISSN1532-5415
KeywordsAged, Aged, 80 and over, Cross-Sectional Studies, Dyspnea, Female, Frail Elderly, Geriatric Assessment, Humans, Lower Extremity, Male, Motor Activity, Muscle Contraction, Prevalence, Retrospective Studies, Spirometry, United States
Abstract<p><b>OBJECTIVES: </b>To evaluate the association between performance on a single chair stand and moderate to severe exertional dyspnea.</p><p><b>DESIGN: </b>Cross-sectional.</p><p><b>SETTING: </b>Cardiovascular Health Study.</p><p><b>PARTICIPANTS: </b>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%)).</p><p><b>MEASUREMENTS: </b>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.</p><p><b>RESULTS: </b>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).</p><p><b>CONCLUSION: </b>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.</p>
DOI10.1111/jgs.13529
Alternate JournalJ Am Geriatr Soc
PubMed ID26200804
Grant ListI01 CX000927 / CX / CSRD VA / United States
P30AG021342 / AG / NIA NIH HHS / United States