title: Aging, diabetes, and hypertension are associated with decreased nasal mucociliary clearance.
abstract: BACKGROUND
  We showed previously that nasal mucociliary clearance was decreased in critically ill elderly subjects, most of whom had diabetes mellitus (DM) and/or hypertension (HTN). To determine if these changes were due to the effects of aging, disease, or critical illness, we studied nasal mucociliary clearance and mucus properties in an ambulatory population consisting of young, elderly, and healthy subjects and those with DM, HTN, or both.
  
  
  METHODS
  Of 440 subjects contacted, 252 entered the study. The subjects were divided into the following groups: (1) healthy (n 5 79, 18-94 years, 50 men) and (2) DM and/or HTN, of which 37 had DM (14-90 years, 12 men), 52 had HTN (23-90 years, 12 men), and 84 had both DM and HTN (25-82 years, 33 men). Subjects were also grouped by age: , 40 years, 40 to 59 years, and 60 years. We assessed demographic and clinical data, quality of life using the 36-Item Short Form Health Survey (SF-36) questionnaire, nasal mucociliary clearance using the saccharine transit test (STT), and in vitro mucus properties by examining the sneeze (high airflow) clearability and contact angle. A logistic regression analysis for prolonged STT . 12 min was used, and we controlled for age, sex, and diseases.
  
  
  RESULTS
  Subjects aged . 60 years reported a decreased SF-36 physical component relative to other age groups. Sex, BMI, BP, heart rate, pulse oximetry, blood glucose level, and mucus properties were not associated with prolonged STT. Aging and DM and/or HTN independently increased the risk of prolonged STT.
  
  
  CONCLUSIONS
  Aging and DM, HTN, or both diseases are independently associated with decreased nasal mucociliary clearance. This may predispose toward respiratory infections.
authors.affiliation: Department of Physiotherapy, Communication Science and Disorders, Occupational Therapy, LIM 34, University of São Paulo City, Brazil; Department of Pathology, LIM 05, University of São Paulo City, Brazil.
authors.forename: Janaína
authors.initials: J
authors.lastname: Proença de Oliveira-Maul
authors.affiliation: Department of Preventive Medicine, LIM 39, University of São Paulo City, Brazil.
authors.forename: Heráclito
authors.initials: H
authors.lastname: Barbosa de Carvalho
authors.affiliation: Department of Physiotherapy, Communication Science and Disorders, Occupational Therapy, LIM 34, University of São Paulo City, Brazil; Department of Pathology, LIM 05, University of São Paulo City, Brazil.
authors.forename: Danielle Miyuki
authors.initials: DM
authors.lastname: Goto
authors.affiliation: Master of Science Program in Physiotherapy, University of São Paulo City, Brazil.
authors.forename: Raphaela Mendonça
authors.initials: RM
authors.lastname: Maia
authors.affiliation: Department of Geriatrics, University of São Paulo City, Brazil.
authors.forename: Claudia
authors.initials: C
authors.lastname: Fló
authors.affiliation: Department of Physiotherapy, Communication Science and Disorders, Occupational Therapy, LIM 34, University of São Paulo City, Brazil; Department of Pathology, LIM 05, University of São Paulo City, Brazil.
authors.forename: Viviane
authors.initials: V
authors.lastname: Barnabé
authors.affiliation: Associação de Diabetes Juvenil, São Paulo, Brazil.
authors.forename: Denise Reis
authors.initials: DR
authors.lastname: Franco
authors.affiliation: Department of Pathology, LIM 05, University of São Paulo City, Brazil.
authors.forename: Simon
authors.initials: S
authors.lastname: Benabou
authors.affiliation: Master of Science Program in Physiotherapy, University of São Paulo City, Brazil.
authors.forename: Monica Rodrigues
authors.initials: MR
authors.lastname: Perracini
authors.affiliation: Department of Geriatrics, University of São Paulo City, Brazil.
authors.forename: Wilson
authors.initials: W
authors.lastname: Jacob-Filho
authors.affiliation: Department of Pathology, LIM 05, University of São Paulo City, Brazil.
authors.forename: Paulo Hilário Nascimento
authors.initials: PHN
authors.lastname: Saldiva
authors.affiliation: Division of Pneumology, Heart Institute, Faculdade de Medicina da Universidade de São Paulo, Brazil.
authors.forename: Geraldo
authors.initials: G
authors.lastname: Lorenzi-Filho
authors.affiliation: Virginia Commonwealth University Department of Pediatrics and Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA.
authors.forename: Bruce K
authors.initials: BK
authors.lastname: Rubin
authors.affiliation: Department of Physiotherapy, Communication Science and Disorders, Occupational Therapy, LIM 34, University of São Paulo City, Brazil; Department of Pathology, LIM 05, University of São Paulo City, Brazil. Electronic address: naomi.kondo@usp.br.
authors.forename: Naomi Kondo
authors.initials: NK
authors.lastname: Nakagawa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000503:physiopathology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009079:Mucociliary Clearance / Q000502:physiology*; D009297:Nasal Mucosa / Q000503:physiopathology*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult