Definition of Respiratory Sarcopenia With Peak Expiratory Flow Rate

Takeshi Kera; Hisashi Kawai; Hirohiko Hirano; Motonaga Kojima; Yutaka Watanabe; Keiko Motokawa; Yoshinori Fujiwara; Kazushige Ihara; Hunkyung Kim; Shuichi Obuchi

doi:10.1016/j.jamda.2018.12.013

Definition of Respiratory Sarcopenia With Peak Expiratory Flow Rate

J Am Med Dir Assoc. 2019 Aug;20(8):1021-1025. doi: 10.1016/j.jamda.2018.12.013. Epub 2019 Feb 6.

Authors

Affiliations

¹ Department of Physical Therapy, Takasaki University of Health and Welfare, Gunma, Japan; Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
² Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
³ Department of Dentistry and Oral Surgery, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan.
⁴ Department of Physical Therapy, University of Tokyo Health Sciences, Tokyo, Japan.
⁵ Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
⁶ Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
⁷ Department of Social Medicine, Hirosaki University School of Medicine, Aomori, Japan.
⁸ Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan. Electronic address: obuchipc@tmig.or.jp.

PMID: 30737167
DOI: 10.1016/j.jamda.2018.12.013

Abstract

Objectives: Respiratory muscle strength decreases with advancing age, and respiratory muscle dysfunction may indicate respiratory sarcopenia. However, there is no consensus regarding the definition of respiratory sarcopenia. We aimed to create a definition of respiratory sarcopenia based on the peak expiratory flow rate (PEFR).

Design: Cross-sectional study.

Setting and participants: Community-based study including 681 community-dwelling older people.

Methods: Body composition, spirometry, grip strength, and walking speed were measured. Participants reported comorbidities and long-term insurance certification. Conventional sarcopenia was defined using skeletal muscle mass, grip strength, and walking speed adjusted for the Japanese population. Receiver operating characteristic (ROC) curve analysis of the cut-off values of PEFR for conventional sarcopenia and long-term care insurance certification were performed for both sexes without airway obstruction. In the ROC curve analysis, potential cut-off values were lowest quartile, lowest quintiles, and the standard deviation of PEFR. Multiple logistic regression analysis was performed with respiratory sarcopenia as a dependent variable defined by each cut-off value and other variants as independent variables.

Results: The ROC curve analysis for conventional sarcopenia and long-term care insurance certification showed significance for both sexes, and we determined cut-off values from those results. The multiple logistic regression model using PEFR values 1 standard deviation below the mean had the highest accuracy; thus, we accepted these cut-off values (4.40 L/s for men, 3.21 L/s for women) for the definition of respiratory sarcopenia.

Conclusions/implications: The definition of respiratory sarcopenia based on PEFR was useful and correlated with conventional sarcopenia and long-term care insurance certification among community-dwelling older people. In this study, respiratory sarcopenia was determined by PEFR alone. Other parameters may need to be considered.

Keywords: Community-dwelling older people; peak expiratory flow rate; respiratory muscle; respiratory muscle sarcopenia; sarcopenia.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Body Composition
Cross-Sectional Studies
Female
Hand Strength
Humans
Independent Living
Japan
Male
Peak Expiratory Flow Rate*
Respiratory Muscles / physiopathology*
Sarcopenia / physiopathology*
Walking Speed