title: Post-mortem brain pathology is related to declining respiratory function in community-dwelling older adults.
abstract: Damage to brain structures which constitute the distributed neural network that integrates respiratory muscle and pulmonary functions, can impair adequate ventilation and its volitional control. We tested the hypothesis that the level of brain pathology in older adults is associated with declining respiratory function measured during life. 1,409 older adults had annual testing with spirometry (SPI) and respiratory muscle strength (RMS) based on maximal inspiratory and maximal expiratory pressures (MEPs). Those who died underwent structured brain autopsy. On average, during 5 years of follow-up, SPI and RMS showed progressive decline which was moderately correlated (ρ = 0.57, p < 0.001). Among decedents (N = 447), indices of brain neuropathologies showed differential associations with declining SPI and RMS. Nigral neuronal loss was associated with the person-specific decline in SPI (Estimate, -0.016 unit/year, S.E. 0.006, p = 0.009) and reduction of the slope variance was equal to 4%. By contrast, Alzheimer's disease (AD) pathology (Estimate, -0.030 unit/year, S.E. 0.009, p < 0.001) and macroscopic infarcts (-0.033 unit/year, S.E., 0.011, p = 0.003) were associated with the person-specific decline in RMS and reduction of the slope variance was equal to 7%. These results suggest that brain pathology is associated with the rate of declining respiratory function in older adults.
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center Chicago, IL, USA ; Department of Neurological Sciences, Rush University Medical Center Chicago, IL, USA.
authors.forename: Aron S
authors.initials: AS
authors.lastname: Buchman
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center Chicago, IL, USA ; Department of Neurological Sciences, Rush University Medical Center Chicago, IL, USA.
authors.forename: Lei
authors.initials: L
authors.lastname: Yu
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center Chicago, IL, USA ; Department of Behavioral Sciences, Rush University Medical Center Chicago, IL, USA.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Wilson
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center Chicago, IL, USA ; Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center Chicago, IL, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Dawe
authors.affiliation: Department of Neurology, Beth Israel Deaconess Medical Center Boston, MA, USA ; Harvard Medical School Boston, MA, USA.
authors.forename: Veronique
authors.initials: V
authors.lastname: VanderHorst
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center Chicago, IL, USA ; Department of Neurological Sciences, Rush University Medical Center Chicago, IL, USA ; Department of Pathology (Neuropathology), Rush University Medical Center Chicago, IL, USA.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Schneider
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center Chicago, IL, USA ; Department of Neurological Sciences, Rush University Medical Center Chicago, IL, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Bennett
keywords: Alzheimer’s disease pathology; aging; macroscopic infarct; neuropathology; nigral neuronal loss; respiratory decline; respiratory muscles; spirometry