Respiratory muscle strength in the elderly. Correlates and reference values. Cardiovascular Health Study Research Group.

Abstract

Maximal inspiratory pressure (MIP) was assessed in 4,443 ambulatory participants of the Cardiovascular Health Study, 65 yr of age and older, sampled from four communities. Maximal expiratory pressure (MEP) was also measured in 790 participants from a single clinic. Positive predictors of MIP included male sex, FVC, handgrip strength, and higher levels of lean body mass (or low bioelectric resistance). Negative predictors were age, current smoking, self-reported fair to poor general health, and waist size. Both participant and technician learning effects were noted, but there was no independent effect of race, hypertension, cardiovascular disease, or diabetes. A healthy subgroup was identified by excluding current smokers, those with fair to poor general health, or an FEV1 less than 65% of predicted. Mean values determined from the healthy group were 57/116 cm H2O (MIP/MEP) for women, and 83/174 for men. Lower limits of the normal range (fifth percentiles) were 45 to 60% of the mean predicted values. The reference equations derived from this group of healthy 65 to 85-yr-olds may be used by pulmonary function laboratories and respiratory therapists who evaluate the respiratory muscle strength of elderly patients.

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

“…34 An association between respiratory muscle strength and ventilatory function was previously reported among older subjects. 12,35 Moreover, our data support a link between ageassociated worsening in lung function and age-associated FFM decline.…”

Maximal respiratory pressure in healthy 20 to 89 year-old sedentary individuals of central São Paulo State

“…They observed that individuals with lower peripheral muscle strength showed effective reduction in respiratory muscle strength. There also appears to be a relationship between upper limb muscle strength and RMS as reported by Enright et al 28 in a study with older adults, in which the authors found a positive correlation between RMS and handgrip values.…”

“…Various hypotheses have tried to explain this negative correlation. Enright et al 28 suggest that it occurs due to the loss of muscle mass, especially in the diaphragm and accessory respiratory muscles. In contrast, other authors 1 believe there is an increase in abdominal compliance with age that dissipates the pressure generated during forced expiration to lower the MEP.…”

“…Studies 1,28 showed that physical inactivity promotes loss of peripheral and respiratory muscle mass. Neder et al 1 reported a positive and significant association between peripheral muscle strength (measured by the knee extensors) and respiratory muscle strength (measured by the MIP and MEP).…”

Reference values for lung function tests: II. Maximal respiratory pressures and voluntary ventilation

“…The aging process is associated with a reduction in the total, diaphragmatic and respiratory accessory muscular mass, as well as with a decline in the work output for a same level of neural stimulation (13). Increased compliance of the abdominal compartment in older subjects can dissipate the generated pressure, notably in the forced expiration, reducing the maximal static pressures.…”