ArticleJournal of the American Geriatrics Society2011
Staging the severity of chronic obstructive pulmonary disease in older persons based on spirometric Z-scores.
Article in Journal of the American Geriatrics Society, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Respiratory impairment and the aging lung: a novel paradigm for assessing pulmonary function.The journals of gerontology. Series A, Biological sciences and medical sciences · 2012Pooled it
- Trial
- Effect of Monthly, High-Dose, Long-Term Vitamin D on Lung Function: A Randomized Controlled Trial.Nutrients · 2017Trial
- Effect of Structured Physical Activity on Respiratory Outcomes in Sedentary Elderly Adults with Mobility Limitations.Journal of the American Geriatrics Society · 2016Trial
- Respiratory impairment and dyspnea and their associations with physical inactivity and mobility in sedentary community-dwelling older persons.Journal of the American Geriatrics Society · 2014Trial
- Spirometric Classifications of Chronic Obstructive Pulmonary Disease Severity as Predictive Markers for Clinical Outcomes: The HUNT Study.American journal of respiratory and critical care medicine · 2021Article
- Validation of Questionnaire-based Case Definitions for Chronic Obstructive Pulmonary Disease.Epidemiology (Cambridge, Mass.) · 2020Article
- Weighing the evidence for pharmacological treatment interventions in mild COPD; a narrative perspective.Respiratory research · 2019Review
- Re-evaluation of combination therapy in chronic obstructive pulmonary disease (COPD).Respiratory medicine · 2019Article
- Article
- Spirometry, Static Lung Volumes, and Diffusing Capacity.Respiratory care · 2017Article
- Aging Airways: between Normal and Disease. A Multidimensional Diagnostic Approach by Combining Clinical, Functional, and Imaging Data.Aging and disease · 2017Review
- GOLD criteria overestimate airflow limitation in one-third of cases in the general Finnish population.ERJ open research · 2016Article
- Aging-Related Considerations When Evaluating the Forced Expiratory Volume in 1 Second (FEV1) Over Time.The journals of gerontology. Series A, Biological sciences and medical sciences · 2016Article
- Phenotype of Spirometric Impairment in an Aging Population.American journal of respiratory and critical care medicine · 2016Article
- Determinants of chronic obstructive pulmonary disease severity in the late-elderly differ from those in younger patients.BMC research notes · 2016Article
- Review
- Phenotype of normal spirometry in an aging population.American journal of respiratory and critical care medicine · 2015Article
- Diagnosis and early detection of COPD using spirometry.Journal of thoracic disease · 2014Review
- Infrastructure and resources for an aging population: embracing complexity in translational research.Translational research : the journal of laboratory and clinical medicine · 2014Review
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
objectivesAmong older persons, the use of spirometric Z-scores as calculated by the Lambda-Mu-Sigma (LMS) method has a strong scientific rationale for establishing a diagnosis of chronic obstructive pulmonary disease (COPD), but its clinical validity in staging COPD severity is not yet known. The current study has therefore evaluated the association between LMS-staged COPD and health outcomes, in two separate cohorts of older persons.
designLongitudinal cohort study.
settingThe Cardiovascular Health Study (CHS, N = 3,248) and the Third National Health and Nutrition Examination Survey (NHANES-III, N = 1,354).
participantsCommunity-living white participants aged 65 to 80. MEASUREMENTS: Using spirometric data, COPD was staged as mild, moderate, or severe based on LMS-derived Z-scores. Clinical validity was then evaluated according to all-cause mortality, respiratory symptoms (chronic bronchitis, dyspnea, or wheezing), and moderate to severe dyspnea (available in CHS only).
resultsIn CHS, the LMS staging of COPD as mild, moderate, and severe was associated with mortality (adjusted HR (aHR) = 1.50, 95% confidence interval (CI) = 1.15-1.94; aHR = 1.31, 95% CI = 1.03-1.67; and aHR = 2.00, 95% CI = 1.70-2.36, respectively) and with respiratory symptoms (adjusted OR (aOR) = 1.69, 95% CI = 1.12-2.56; aOR = 1.87, 95% CI = 1.28-2.73; and aOR = 3.99, 95% CI = 2.91-5.48, respectively). Also in CHS, moderate and severe, but not mild, LMS-staged COPD was associated with moderate to severe dyspnea (aOR = 2.16, 95% CI = 1.24-3.75; aOR = 3.98, 95% CI = 2.77-5.74; and aOR = 0.84, 95% CI = 0.35-2.01, respectively). Similar associations were found for mortality and respiratory symptoms in NHANES-III, except mild severity was not associated with mortality (aHR = 0.93, 95% CI = 0.62-1.40).
conclusionIn white older persons, the spirometric staging of COPD severity based on LMS-derived Z-scores was associated with several clinically relevant health outcomes. These results support the use of the LMS method for staging the severity of COPD in older populations.
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