Free Content Three phenotypes of obstructive lung disease in the elderly

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Abstract:

SETTING: Eleven referring hospitals in South Korea.

OBJECTIVE: To classify the phenotypes in elderly subjects with obstructive lung disease (OLD).

METHODS: We analysed 191 subjects aged ≥60 years with chronic respiratory symptoms and either obstructive spirometry or bronchial hyperresponsiveness. Factor analysis was performed using commonly measured variables and revealed four significant variables: 1) the ratio of inspiratory capacity to total lung capacity, 2) the total score on the St George's Respiratory Questionnaire, 3) the volume fraction of the lung less than 950 Hounsfield Unit at full inspiration on volumetric computed tomography and 4) post-bronchodilator forced expiratory volume in 1 second (FEV1) changes. We performed a cluster analysis on these four variables.

RESULTS: The mean age was 68.5 (±5.2 SD) years and the mean post-bronchodilator FEV1 was 52.4% (±16.5) predicted. Three clusters with the following phenotypes were identified: Cluster 1 included subjects with moderate to severe airflow obstruction and bronchodilator reversibility; Cluster 2 subjects had moderate airflow obstruction without bronchodilator reversibility, and Cluster 3 subjects had severe airflow obstruction without bronchodilator reversibility.

CONCLUSIONS: We identified three phenotypes in elderly subjects with OLD. Follow-up studies are needed to explore the clinical significance of each phenotype.

Keywords: asthma; chronic bronchitis; elderly; emphysema; obstructive lung disease

Document Type: Regular Paper

Affiliations: 1: Department of Pulmonary and Critical Care Medicine & Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea 2: Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea 3: Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea 4: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Bundang CHA Hospital, College of Medicine, CHA University, Seongnam, Republic of Korea 5: Department of Radiology, East-West Neo Medical Center, Kyunghee University, Seoul, Republic of Korea 6: Division of Pulmonology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea 7: Department of Internal Medicine, College of Medicine, Kangwon National University, Chuncheon, Republic of Korea 8: Department of Internal Medicine, Ewha Womans University Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul, Republic of Korea 9: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea 10: Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea 11: Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea 12: Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Republic of Korea

Publication date: November 1, 2010

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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