title: Prevalence and correlates of respiratory symptoms and disease in the elderly. Cardiovascular Health Study.
abstract: Spirometry was performed by 5,201 elderly participants of the Cardiovascular Health Study during their baseline examination and a subset of the ATS/DLD-78 respiratory questionnaire was administered by trained interviewers. In never smokers (46 percent of the cohort), the overall prevalence of chronic cough was 9 percent, chronic phlegm was 13 percent, attacks of wheezing with dyspnea were 8 percent, and grade 3 dyspnea on exertion was 10 percent. The prevalence of lung disease in current smokers (12 percent of the cohort) was 8/7 percent (men/women) with chronic bronchitis and 14/5 percent with emphysema. Overall, 6 percent reported asthma (a physician-confirmed history) and 12 percent reported hay fever. Using a logistic regression model, attacks of wheezing with dyspnea were strongly associated with a lower FEV1, coronary heart disease, heart failure, and a large waist size (in participants without a diagnosis of asthma, chronic bronchitis, or emphysema). Undiagnosed airways obstruction was twice as likely in women and those with lower income, and was associated with current and former smoking, pack-years of smoking, and chronic cough. Dyspnea on exertion (DOE) was three times or more likely if a participant reported heart failure, coronary heart disease, or emphysema; and much more likely if their FEV1 or FVC was substantially reduced. Dyspnea on exertion was also positively associated with older age, chronic bronchitis or asthma, a larger waist or hip size, pack-years of smoking, and less education. We conclude that DOE and attacks of wheezing with dyspnea are commonly associated with cardiovascular disease and a low FEV1 in those over 65 years and that airways obstruction frequently remains undiagnosed in the elderly.
authors.affiliation: CHS Coordinating Center, Seattle 98101.
authors.forename: P L
authors.initials: PL
authors.lastname: Enright
authors.forename: R A
authors.initials: RA
authors.lastname: Kronmal
authors.forename: M W
authors.initials: MW
authors.lastname: Higgins
authors.forename: M B
authors.initials: MB
authors.lastname: Schenker
authors.forename: E F
authors.initials: EF
authors.lastname: Haponik
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008396:Maryland / Q000453:epidemiology; D015999:Multivariate Analysis; D009657:North Carolina / Q000453:epidemiology; D010414:Pennsylvania / Q000453:epidemiology; D015995:Prevalence; D011379:Prognosis; D012140:Respiratory Tract Diseases / Q000175:diagnosis / Q000453:epidemiology*; D013147:Spirometry / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires