title: Predictors of poor-quality spirometry in two cohorts of older adults in Russia and Belgium: a cross-sectional study.
abstract: BACKGROUND
  Spirometry is an important test for the diagnosis of respiratory diseases, yet it is underused especially in older adults. Several predictors of good-quality spirometry in this age group have been reported, based mainly on in/outpatients of geriatric and/or respiratory units.
  
  
  OBJECTIVE
  This study aims to assess predictors of poor-quality spirometry in community-dwelling older adults from two primary care cohorts in Russia and Belgium.
  
  
  METHODS
  Spirograms from two population-based cohort studies in Russia (CRYSTAL) and Belgium (BELFRAIL) were assessed in accordance with the American Thoracic Society/European Respiratory Society (ATS/ERS) acceptability and repeatability criteria and grouped into good and poor quality. Multivariable analysis assessed the association of poor-quality spirometry with socio-demographics, functional dependency, physical and mental functioning and co-morbidities.
  
  
  RESULTS
  In all, 43.3% of the 522 BELFRAIL participants (84.71 ± 3.67 years old) and 57.7% of the 605 CRYSTAL participants (75.11 ± 5.97 years old) achieved all ATS/ERS acceptability and repeatability criteria. In both cohorts, those with poor-quality spirometry had lower cognitive function (mini-mental state examination (MMSE) ⩽ 24). After adjustment in multivariable analysis, MMSE ⩽ 24 had an odds ratio for poor-quality spirometry of 1.33 (95% CI = 0.78-2.28) in the BELFRAIL and 1.30 (95% CI = 0.88-1.91) in the CRYSTAL cohort.
  
  
  CONCLUSIONS
  In community-dwelling older adults, including those over 80 years old, impaired cognition measured by the MMSE may not be an independent predictor of poor-quality spirometry. Further research is needed in this area, and spirometry should be used more often in older adults in primary care.
authors.affiliation: Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Eralda
authors.initials: E
authors.lastname: Turkeshi
authors.affiliation: Department of Family Medicine, North-Western State Medical University, St Petersburg, Russia.
authors.forename: Dmitry
authors.initials: D
authors.lastname: Zelenukha
authors.affiliation: 1] Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium [2] Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: Bert
authors.initials: B
authors.lastname: Vaes
authors.affiliation: Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Elena
authors.initials: E
authors.lastname: Andreeva
authors.affiliation: Department of Family Medicine, North-Western State Medical University, St Petersburg, Russia.
authors.forename: Elena
authors.initials: E
authors.lastname: Frolova
authors.affiliation: 1] Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium [2] Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Degryse
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000175:diagnosis* / Q000453:epidemiology; D001530:Belgium; D003071:Cognition; D003072:Cognition Disorders / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D057187:Independent Living; D008297:Male; D008609:Mental Status Schedule; D011320:Primary Health Care; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000453:epidemiology; D012307:Risk Factors; D012426:Russia; D013147:Spirometry / Q000592:standards*