title: Predictive Value of Different Expressions of Forced Expiratory Volume in 1 Second (FEV1) for Adverse Outcomes in a Cohort of Adults Aged 80 and Older.
abstract: OBJECTIVE
  Forced expiratory volume in 1 second (FEV1) is proposed as a marker of healthy ageing and FEV1expressions that are independent of reference values have been reported to be better at predicting mortality in older adults. We assess and compare the predictive value of different FEV1expressions for mortality, hospitalization, and physical and mental decline in adults aged 80 and older.
  
  
  METHODS
  Population-based, prospective, cohort study.
  
  
  METHODS
  The BELFRAIL study, Belgium.
  
  
  METHODS
  A total of 501 community-dwelling adults aged 80 and older (mean age 84.7 years).
  
  
  METHODS
  Baseline FEV1expressed as percent predicted (FEV1PP) and z-score (FEV1Z) using the Global Lung Function Initiative 2012 reference values; over lowest sex-specific percentile (FEV1Q), and height squared (FEV1/Ht2) and cubed (FEV1/Ht3). Mortality data until 5.1 ± 0.2 years from baseline; hospitalization data until 3.0 ± 0.25 years. Activities of daily living, battery of physical performance tests, Mini-Mental State Examination, and 15-item Geriatric Depression Scale at baseline and after 1.7 ± 0.2 years.
  
  
  RESULTS
  Individuals in the lowest quartile of FEV1expressions had higher adjusted risk than the rest of study population for all-cause mortality (highest hazard ratio 2.05 [95% Confidence Interval 1.50-2.80] for FEV1Q and 2.01 [1.47-2.76] for FEV1/Ht3), first hospitalization (highest hazard ratio 1.63 [1.21-2.16] for FEV1/Ht2and 1.61[1.20-2.16] for FEV1/Ht3), mental decline (highest odds ratio 2.80 [1.61-4.89] for FEV1Q) and physical decline (only FEV1/Ht3with odds ratio 1.93 [1.13-3.30]). Based on risk classification improvement measures, FEV1/Ht3and FEV1Q performed better than FEV1PP.
  
  
  CONCLUSIONS
  In a cohort of adults aged 80 and older, FEV1expressions that are independent of reference values (FEV1/Ht3and FEV1Q) were better at predicting adverse health outcomes than traditional expressions that depend on reference values, and should be used in further research on FEV1and aging.
authors.affiliation: Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium; Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium. Electronic address: eralda.turkeshi@kuleuven.be.
authors.forename: Eralda
authors.initials: E
authors.lastname: Hegendörfer
authors.affiliation: Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium; 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 Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: Catharina
authors.initials: C
authors.lastname: Matheï
authors.affiliation: Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: Gijs
authors.initials: G
authors.lastname: Van Pottelbergh
authors.affiliation: Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium; Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Degryse
mesh_terms: D000369:Aged, 80 and over; D000375:Aging; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology*; D015577:Geriatric Assessment; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D009026:Mortality / Q000639:trends; D011379:Prognosis; D011446:Prospective Studies; D012129:Respiratory Function Tests; D018570:Risk Assessment
keywords: FEV1 expressions; adults aged 80 and older; adverse health outcomes