title: Performing slow vital capacity in older people with and without cognitive impairment--is it useful?
abstract: BACKGROUND
  most patients with moderate cognitive impairment are unable to perform forced spirometry. It has been suggested that slow vital capacity (SVC) is easier to perform than forced vital capacity (FVC) because it requires less understanding and co-ordination. We conducted a study to determine whether that assertion is correct.
  
  
  METHODS
  we studied 83 inpatients, mean age 83 years (range 67-95, 51 female). They had measurements made of FVC, SVC and the Mini-Mental State Examination (MMSE). The spirometry was conducted using the European Respiratory Society/American Thoracic Society standards.
  
  
  RESULTS
  of the 83 subjects, 38 were able to do both FVC and SVC and 32 were unable to do either. The overall concordance was 84%. Twelve were able to do SVC but not FVC (eight due to excessive cough, two due to weakness and two had an MMSE < 24 with poor co-ordination). An inability to do neither FVC nor SVC was predicted by an MMSE < 24/30 (P < 0.0001) with a sensitivity of 88% and specificity of 67%.
  
  
  CONCLUSIONS
  SVC is not a usable substitute for FVC for elderly patients with cognitive impairment but is of some utility for those who tend to cough. An MMSE < 24/30 is predictive of inability to perform FVC and SVC.
authors.affiliation: Department of Medicine and Geriatrics, The Royal Bournemouth Hospital, Dorset, UK. stephen.allen@rbch.nhs.uk
authors.forename: S C
authors.initials: SC
authors.lastname: Allen
authors.forename: C
authors.initials: C
authors.lastname: Charlton
authors.forename: W
authors.initials: W
authors.lastname: Backen
authors.forename: M
authors.initials: M
authors.lastname: Warwick-Sanders
authors.forename: P
authors.initials: P
authors.lastname: Yeung
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D003071:Cognition / Q000502:physiology; D003072:Cognition Disorders / Q000503:physiopathology*; D003371:Cough / Q000209:etiology; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D010349:Patient Compliance; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013147:Spirometry / Q000009:adverse effects / Q000379:methods*; D014797:Vital Capacity / Q000502:physiology*