title: Lower Extremity Proximal Muscle Function and Dyspnea in Older Persons.
abstract: OBJECTIVE
  To evaluate the association between performance on a single chair stand and moderate to severe exertional dyspnea.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Cardiovascular Health Study.
  
  
  METHODS
  Community-dwelling individuals aged 65 and older (N = 4,413; mean age 72.6; female, n = 2,518 (57.1%); nonwhite, n = 199 (4.5%); obese, n = 788 (17.9%); history of smoking, n = 2,410 (54.6%)).
  
  
  METHODS
  Performance on single chair stand (poor (unable to rise without arm use) vs normal (able to rise without arm use)), moderate to severe exertional dyspnea (American Thoracic Society grade ≥2), age, sex, ethnicity, obesity, smoking, frailty status (Fried-defined nonfrail, prefrail, frail), high cardiopulmonary risk (composite of cardiopulmonary diseases and diabetes mellitus), spirometric impairment, arthritis, depression, stroke, and kidney disease.
  
  
  RESULTS
  Poor performance on the single chair stand was established in 369 (8.4%) and moderate to severe exertional dyspnea in 773 (17.5%). Prefrail status was established in 2,210 (50.1%), frail status in 360 (8.2%), arthritis in 2,241 (51.4%), high cardiopulmonary risk in 2,469 (55.9%), spirometric impairment in 1,076 (24.4%), kidney disease in 111 (2.5%), depression in 107 (2.4%), and stroke in 93 (2.1%). In multivariable regression models, poor performance on the single chair stand was associated with moderate to severe exertional dyspnea (unadjusted odds ratio (OR) = 3.48, 95% confidence interval (CI) = 2.78-4.36; adjusted OR = 1.85, 95% CI = 1.41-2.41).
  
  
  CONCLUSIONS
  Poor performance on a single chair stand was associated with an adjusted 85% greater likelihood of moderate to severe exertional dyspnea than normal performance. These results suggest that reduced proximal muscle function of the lower extremities is associated with moderate to severe exertional dyspnea, even after adjusting for multiple confounders.
authors.affiliation: Department of Internal Medicine, School of Medicine, Yale University, West Haven, Connecticut.|Clinical Epidemiology Research Center, Veterans Affairs Connecticut, West Haven, Connecticut.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Vaz Fragoso
authors.affiliation: Department of Internal Medicine, School of Medicine, Yale University, West Haven, Connecticut.
authors.forename: Katy
authors.initials: K
authors.lastname: Araujo
authors.affiliation: Department of Internal Medicine, School of Medicine, Yale University, West Haven, Connecticut.
authors.forename: Linda
authors.initials: L
authors.lastname: Leo-Summers
authors.affiliation: Department of Internal Medicine, School of Medicine, Yale University, West Haven, Connecticut.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Van Ness
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004417:Dyspnea / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology*; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D009119:Muscle Contraction / Q000502:physiology*; D015995:Prevalence; D012189:Retrospective Studies; D013147:Spirometry; D014481:United States / Q000453:epidemiology
keywords: chair stand; dyspnea; spirometry