Journal
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
Volume 20, Issue 8, Pages 1021-1025Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jamda.2018.12.013
Keywords
Community-dwelling older people; peak expiratory flow rate; respiratory muscle; respiratory muscle sarcopenia; sarcopenia
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Funding
- JSPS KAKENHI [16K01853]
- 2017 Health and Labour Sciences Research Grants from the Ministry of Health, Labour and Welfare of Japan [39-64, 40-72]
- 2017 Research Funding for Longevity Sciences from the National Center for Geriatrics and Gerontology (NCGG), Japan [28-30, 29-42]
- Grants-in-Aid for Scientific Research [16K01853] Funding Source: KAKEN
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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. (C) 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
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