Aging-related trajectories of lung function in the general population—The Doetinchem Cohort Study

Abstract

The objective of this study was to explore trajectories of lung function decline with age in the general population, and to study the effect of sociodemographic and life style related risk factors, in particular smoking and BMI. For this purpose, we used data from the Doetinchem Cohort Study (DCS) of men and women, selected randomly from the general population and aged 20–59 years at inclusion in 1987–1991, and followed until the present. Participants in the DCS are assessed every five years. Spirometry has been performed as part of this assessment from 1994 onwards. Participants were included in this study if spirometric measurement of FEV1, which in this study was the main parameter of interest, was acceptable and reproducible on at least one measurement round, leading to the inclusion of 5727 individuals (3008 females). Statistical analysis revealed three typical trajectories. The majority of participants followed a trajectory that closely adhered to the Global Lung Initiative Reference values (94.9% of men and 96.4% of women). Two other trajectories showed a more pronounced decline. Smoking and the presence of respiratory complaints were the best predictors of a trajectory with stronger decline. A greater BMI over the follow-up period was associated with a more unfavorable FEV1 course both in men (β = -0.027 (SD = 0.002); P < 0.001) and in women (β = -0.008 (SD = 0.001); P < 0.001). Smokers at baseline who quit the habit during follow-up, showed smaller decline in FEV1 in comparison to persistent smokers, independent of BMI change (In men β = -0.074 (SD = 0.020); P < 0.001. In women β = -0.277 (SD = 0.068); P < 0.001). In conclusion, three typical trajectories of age-related FEV1 decline could be distinguished. Change in the lifestyle related risk factors, BMI and smoking, significantly impact aging-related decline of lung function. Identifying deviant trajectories may help in early recognition of those at risk of a diagnosis of lung disease later in life.

Spirometry parameters in smokers and non-smokers with and without respiratory symptoms in the PURE Poland Study population

“…In our study, FEV1/FVC decline was most prevalent among former smokers, contrary to the results obtained in other studies [20,21], in which quitting smoking was associated with improved lung function. On the other hand, smoking cessation can be associated with weight gain, and increased body mass index (BMI) was associated with lower lung function [22], but we can only speculate that this phenomenon partially explains our observation.…”

Physical performances show conflicting associations in aged manual workers

“…Taken together, the results of the present study show that handgrip force was greater than that seen in general populations highlighting that physical work preserves strength. Paradoxically, cardiorespiratory fitness and lung function were poorer and decreased at similar rates in manual workers as those seen in other studies 5,43 . These findings solidify further the health paradox stating that occupational and leisure-time physical activity cause opposing effects 10,16,51 .…”

“…However, only absolute and not www.nature.com/scientificreports www.nature.com/scientificreports/ relative  VO 2 max was related with age thus arguing that this association was driven primarily through age-related changes in body size. After the age of 30 years, FEV 1 and FVC have been shown to decline at a rate of about −0.8%/year and −0.6%/year in the Dutch population 5 . With comparable proportions of smokers between studies, our findings were similar to the Dutch study albeit with a slightly greater estimated decline in the simple regression models.…”

P53 in the impaired lungs

“…Aged lungs are prone to infectious diseases due to decreased mucociliary clearance, impaired innate and adaptive immunity [ [81] , [82] , [83] , [84] , [85] , [86] , [87] , [88] ]. In mouse pneumonia models, the cytokines and chemokine levels were higher in aged mice [ 85 ].…”