Body composition and pulmonary function in the elderly: a 7-year longitudinal study

Abstract

Objective: To evaluate over a 7-year follow-up period the relationships between changes in body composition, fat distribution and pulmonary function in a sample of elderly men and women. Design: Longitudinal clinical study. Subjects: A total of 47 women and 30 men aged 71.6±2.3 and 71.7±2.2 years, respectively, at baseline with body mass index (BMI) values of 24.96 ± 3.28 and 27.04 ± 3.35 kg m À2 were followed for 7 years. Measurements: Body weight, waist circumference, sagittal abdominal diameter (SAD), fat-free mass (FFM) and fat mass as measured by dual energy X-ray absorptiometry (DXA) and forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) by spirometry were evaluated at baseline and after a 7-year mean follow-up. Results: In women as in men there were no significant changes in weight, SAD and BMI. A significant decrease in height and FFM was observed in both women and men. Height-adjusted FEV1 and FVC decreased significantly in women and men over the 7-year follow-up. Changes in SAD were the most powerful predictors of 7-year follow-up of FEV1 and FVC after taking into account, respectively, baseline FEV1 and FVC. Linear regression analysis, performed by using 7-year follow-up lung function variables as dependent variables and changes in body composition variables as independent variables, showed that 1 cm SAD increase predicted a decrease in FEV1 and FVC of 31 and 46 ml, respectively, and 1 kg FFM decrease predicted a decrease in FVC of 38 ml. After subdividing our study population into four categories of change in FFM and SAD, patients with decreased FFM and increased SAD showed the highest probability of having a worsening in FEV1 and FVC. Conclusion: Increase in abdominal fat and FFM decline are significant predictors of lung function decline in the elderly. Old subjects developing both abdominal fat gain and FFM loss show the highest probability of developing worsening in lung function.

Effects of omalizumab in severe asthmatics across ages: A real life Italian experience

“…In figure 1 [20][21][22][23]; 20 [18][19][20][21][22]; measured in subjects with younger, medium and older age respectively). However, the improvement of ACT observed after Omalizumab was lower in asthmatics over 65 years (20 [18-22]) when compared with younger subjects aged 18-39 years (24 [22][23][24][25]; p=0.039; figure 2).…”

“…These different characteristics may increase disease severity and therefore reduce the response to treatment in the elderly. In fact, overweight/obese status, with an increased subcutaneous and visceral abdominal fat mass, which is a characteristics of elderly subjects, is a risk factor for a higher airway hyperresponsiveness (AHR), lung function decline and risk of asthma (18)(19)(20)(21)(22)(23)(24). Furthermore, in obesity, lung volume and tidal volume are reduced, thus promoting airway narrowing (20,24,25).…”

Body size and physical activity in relation to incidence of chronic obstructive pulmonary disease

“…One cohort study 23 of visceral fat and respiratory function did not exclude patients with COPD at baseline, so the relation of visceral fat to COPD incidence could not be established. Another cohort study 24 observed that a decline in respiratory function during follow-up was associated with a gain in visceral fat mass during follow-up but was not able to discern whether the gain in visceral fat mass was the cause or the consequence of the decline in respiratory function.…”

The association between daily calcium intake and sarcopenia in older, non-obese Korean adults: the fourth Korea national health and nutrition examination survey (KNHANES IV) 2009

“…Numerous studies have shown age-related body composition changes in both men and women, notably that fat mass increases and muscle mass decreases with age [9,10]. Sarcopenia is an evolving concept and the current definition includes both a loss of muscle strength and loss of muscle mass [11].…”