title: Airflow limitation by the Global Lungs Initiative equations in a cohort of very old adults.
abstract: The cut-off for forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) defining airflow limitation for chronic obstructive pulmonary disease (COPD) is still contested. We assessed airflow limitation prevalence by the lower limit of normal (LLN) of Global Lungs Initiative (GLI) 2012 reference values and its predictive ability for all-cause mortality and hospitalisation in very old adults (aged ≥80 years) compared with the fixed cut-off. In a Belgian population-based prospective cohort of 411 very old adults, airflow limitation prevalence by the 5th percentile of GLI 2012 z-scores (GLI-LLN) and fixed cut-off (0.70) were compared with COPD reported by general practitioners (GPs). Survival and Cox regression multivariable analysis assessed the association of airflow limitation by both cut-offs with 5-year all-cause mortality and first hospitalisation at 3 years. 9.2% had airflow limitation by GLI-LLN and 27% by fixed cut-off, without good agreement (kappa coefficient ≤0.40) with GP-reported COPD (9%). Only airflow limitation by GLI-LLN was independently associated with mortality (adjusted hazard ratio 2.10, 95% CI 1.30-3.38). FEV1/FVC <0.70 but ≥GLI-LLN (17.8%) had no significantly higher risk for mortality or hospitalisation. In a cohort of very old adults, airflow limitation by GLI-LLN has lower prevalence than by fixed cut-off, independently predicts all-cause mortality and does not miss individuals with significantly higher all-cause mortality and hospitalisation.
authors.affiliation: Institute of Health and Society, Université Catholique de Louvain (UCL), Brussels, Belgium eralda.turkeshi@student.uclouvain.be.
authors.forename: Eralda
authors.initials: E
authors.lastname: Turkeshi
authors.affiliation: Institute of Health and Society, Université Catholique de Louvain (UCL), Brussels, Belgium Dept of Public Health and Primary Care, Katholieke Universiteit Leuven (KUL), Leuven, Belgium.
authors.forename: Bert
authors.initials: B
authors.lastname: Vaes
authors.affiliation: Institute of Health and Society, Université Catholique de Louvain (UCL), Brussels, Belgium.
authors.forename: Elena
authors.initials: E
authors.lastname: Andreeva
authors.affiliation: Institute of Health and Society, Université Catholique de Louvain (UCL), Brussels, Belgium Dept of Public Health and Primary Care, Katholieke Universiteit Leuven (KUL), Leuven, Belgium.
authors.forename: Catharina
authors.initials: C
authors.lastname: Matheï
authors.affiliation: Institute of Health and Society, Université Catholique de Louvain (UCL), Brussels, Belgium Dept of Public Health and Primary Care, Katholieke Universiteit Leuven (KUL), Leuven, Belgium.
authors.forename: Wim
authors.initials: W
authors.lastname: Adriaensen
authors.affiliation: Institute of Health and Society, Université Catholique de Louvain (UCL), Brussels, Belgium Dept of Public Health and Primary Care, Katholieke Universiteit Leuven (KUL), Leuven, Belgium.
authors.forename: Gijs
authors.initials: G
authors.lastname: Van Pottelbergh
authors.affiliation: Institute of Health and Society, Université Catholique de Louvain (UCL), Brussels, Belgium Dept of Public Health and Primary Care, Katholieke Universiteit Leuven (KUL), Leuven, Belgium.
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Degryse
mesh_terms: D000369:Aged, 80 and over; D001530:Belgium; D005260:Female; D005541:Forced Expiratory Volume; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D008168:Lung / Q000503:physiopathology*; D008171:Lung Diseases / Q000503:physiopathology*; D008297:Male; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D013147:Spirometry; D014797:Vital Capacity