Neurodegenerative Disorders Increase Decline in Respiratory Muscle Strength in Older Adults

Sanches, Vinicius Santos; Santos, Fabiana Maria dos; Fernandes, Janainny Magalhães; Santos, Mara Lisiane Moraes dos; Müller, Paulo de Tarso; Christofoletti, Gustavo

doi:10.4187/respcare.03063

Cited by 23 publications

(26 citation statements)

References 38 publications

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“…By contrast, AD pathology and macroinfarcts were associated with RMS but not with SPI. This latter association extends prior reports in this cohort of a link between decreased muscle bulk and RMS in old age with incident mild cognitive impairment (MCI) and AD (Buchman et al, 2005 ; Boyle et al, 2009 ; Sanches et al, 2014 ). The varied associations observed in the current study, underscores the importance of analyzing different components of the respiratory network separately, since these findings would not be apparent if only one aspect is measured.…”

Section: Discussionsupporting

confidence: 88%

Post-mortem brain pathology is related to declining respiratory function in community-dwelling older adults

Buchman

Wilson

et al. 2015

Front. Aging Neurosci.

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Damage to brain structures which constitute the distributed neural network that integrates respiratory muscle and pulmonary functions, can impair adequate ventilation and its volitional control. We tested the hypothesis that the level of brain pathology in older adults is associated with declining respiratory function measured during life. 1,409 older adults had annual testing with spirometry (SPI) and respiratory muscle strength (RMS) based on maximal inspiratory and maximal expiratory pressures (MEPs). Those who died underwent structured brain autopsy. On average, during 5 years of follow-up, SPI and RMS showed progressive decline which was moderately correlated (ρ = 0.57, p < 0.001). Among decedents (N = 447), indices of brain neuropathologies showed differential associations with declining SPI and RMS. Nigral neuronal loss was associated with the person-specific decline in SPI (Estimate, −0.016 unit/year, S.E. 0.006, p = 0.009) and reduction of the slope variance was equal to 4%. By contrast, Alzheimer’s disease (AD) pathology (Estimate, −0.030 unit/year, S.E. 0.009, p < 0.001) and macroscopic infarcts (−0.033 unit/year, S.E., 0.011, p = 0.003) were associated with the person-specific decline in RMS and reduction of the slope variance was equal to 7%. These results suggest that brain pathology is associated with the rate of declining respiratory function in older adults.

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Section: Discussionsupporting

confidence: 88%

Post-mortem brain pathology is related to declining respiratory function in community-dwelling older adults

Buchman

Wilson

et al. 2015

Front. Aging Neurosci.

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“…Hence, the study's findings do not permit exploration of the pathophysiology of respiratory dysfunction in PD patients or the extent to which such dysfunction represents PD, associated physical decline, or normative aging. PD has been found to exacerbate the normative age-related loss of respiratory muscle strength [27], and PD-associated deficits in maximum inspiratory and expiratory pressures have been attributed to rigidity and bradykinesia of thoracic musculature [1]. Nevertheless, the precise causal relation of parkinsonism to respiratory dysfunction remains unknown [1].…”

Section: Discussionmentioning

confidence: 99%

Prospective evaluation of pulmonary function in Parkinson's disease patients with motor fluctuations

Hampson

Kieburtz²,

LeWitt

et al. 2016

International Journal of Neuroscience

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Background. Spirometry patterns suggesting restrictive and obstructive pulmonary dysfunction have been reported in Parkinson's disease (PD). However, the patterns' precise relation to PD pathophysiology remains unclear. Purpose/Aim. To assess ON-versus OFF-state pulmonary function, the quality of its spirometric evaluation, and the quality of longitudinal spirometric findings in a large sample of PD patients with motor fluctuations. Methods. During a placebo-controlled trial of an inhaled levodopa formulation, CVT-301, in PD patients with ≥2 h/d of OFF time, spirometry was performed by American Thoracic Society (ATS) guidelines at screening and throughout the 4-week treatment period. Results. Among 86 patients, mean motor impairment during an OFF state at screening was moderately severe. However, mean spirometry results at screening were within normal ranges, and in a mixed model for repeated measures (MMRM), the results at screening were not dependent on motor state (ON vs. OFF). In the placebo group (n = 43), 76% of ON-state and 81% of OFF-state examinations throughout the study met ATS quality metrics, and in an MMRM analysis, mean findings at these patients' arrivals for treatment-period visits showed no significant 4-week change. Across all 86 patients, flow-volume curves prior to any study-drug administration showed only a 3% incidence of "sawtooth" morphology. Conclusions. In PD patients with motor fluctuations, longitudinal spirometry of acceptable quality was generally obtained. Although mean findings were normal, about a quarter of spirograms did not meet ATS quality criteria. Spirogram morphology may be less indicative of various forms of respiratory dysfunction than has previously been reported in PD.

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“…(5,6) Therefore, it is important to assess respiratory muscle strength and lung function, as well as their impact on motor function, in patients with PD in order to implement therapeutic interventions aimed at improving respiratory muscle strength, lung function, and quality of life. (7,8) The objective of the present study was to investigate parameters of lung function and respiratory muscle strength in different stages of PD, as well as to determine their correlation with motor function and quality of life.…”

Section: Introductionmentioning

confidence: 99%

Respiratory muscle strength and lung function in the stages of Parkinson’s disease

et al. 2019

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Objective: To investigate parameters of lung function and respiratory muscle strength in different stages of Parkinson’s disease (PD), as well as to determine their correlation with motor function and quality of life. Methods: This was a cross-sectional study conducted at a referral center for PD in the city of Recife, Brazil. Respiratory muscle strength and lung function, as well as their relationship with motor function and quality of life, were evaluated in patients with PD, stratified by the level of severity, and were compared with the data obtained for a control group. After confirming the normality of data distribution, we performed one-way ANOVA with a post hoc t-test. Results: The sample comprised 66 individuals, in two groups: PD (n = 49) and control (n = 17). All of the parameters investigated showed inverse correlations with PD severity, and there were significant differences among the levels of severity, as well as between the PD and control groups, in terms of the MIP, MEP, FVC, FEV1, and FEF25-75%. The lung function parameters also showed moderate to weak inverse correlations with bradykinesia and rigidity. On a quality of life questionnaire, the total score and mobility domain score both presented a moderate inverse correlation with FVC, FEV1, PEF, and MEP. Conclusions: Respiratory muscle strength and some lung function parameters are impaired from the early stages of PD onward, bradykinesia and rigidity being the cardinal signs that correlate most strongly with impairment of those parameters. Such alterations negatively affect the quality of life of patients with PD.

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Neurodegenerative Disorders Increase Decline in Respiratory Muscle Strength in Older Adults

Cited by 23 publications

References 38 publications

Post-mortem brain pathology is related to declining respiratory function in community-dwelling older adults

Post-mortem brain pathology is related to declining respiratory function in community-dwelling older adults

Prospective evaluation of pulmonary function in Parkinson's disease patients with motor fluctuations

Respiratory muscle strength and lung function in the stages of Parkinson’s disease

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