Changes in lung function in older people from the English Longitudinal Study of Ageing

Abstract

Background: Decline in lung function with increasing age is common in older people. However, the rate of decline using the forced expiratory volume in 1 s (FEV₁) in a longitudinal study in the elderly community dwellers is unknown. Methods: We analyzed data from the English Longitudinal Study of Ageing on people 50 years and older who had FEV₁ measurement at Wave 2 and Wave 4 of 4 years of follow-up, respectively. A random coefficient model was employed to examine the changes in FEV₁ and predict differences in the levels of FEV₁ in older people. Results: A total of 4224 participants were included in the study. The mean (± standard deviation [SD]) rate of change in FEV₁ was a decline of 32.92 ± 0.96 ml/year. The absolute difference in mean FEV₁ level between female and male participants was 767.07 ± 16.6 ml. It was 253.91 ± 22.7 ml lower in current smokers than in nonsmokers, 73.67 ± 18.67 ml lower in participants with a history of sputum in winter months than in participants without sputum, 63.32 ± 7.07 ml lower in participants with a higher dyspnea score than in participants with a lower dyspnea score and 67.77 ± 15.87 ml higher in participants with good health compared to participants with fair/poor health status. One microgram increase in C-reactive protein level lowered FEV₁ by 4.66 ± 0.86 ml and one Hb of hemoglobin increased the FEV₁ level by 4.78 ± 0.77 ml. All were statistically significant at p < 0.001. Conclusions: The average rate of FEV₁ decline in older people without respiratory diseases was found to be high. Lower level of FEV₁ was also observed in current smokers, females, those with a history of sputum in winter months and in participants with higher dyspnea score or in those with poorer health status.

Keywords::

• COPD
• ELSA
• FEV₁
• longitudinal study
• lung function
• older people

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Unrecognized lung function impairment is common among older people.

• Cigarette smoking has deleterious effects on forced expiratory volume in 1 s.

• Increased rate of lung function decline was found in females, those with a history of sputum in winter months and in participants with higher dyspnea score or with poorer health status.

• Smoking cessation program is worthy of consideration as a public health agenda in community settings.