Abstract
Objectives
Previous studies showed that peak expiratory flow (PEF) is associated with health-related
outcomes in advanced age, but the extent to which it may be related to falls risk
remains unclear. We aimed to detect the association between PEF and injurious falls
in older adults and to explore the role of cognitive and physical deficits in this
association.
Design
Prospective study with a 6-year follow-up.
Setting and Participants
The study involves 2234 community-dwelling older adults with no history of pulmonary
disease.
Methods
For each study participant, we assessed the PEF at baseline, expressed as standardized
residual (SR) percentile and derived from the normalization of residuals between the
measured and predicted PEF values (based on individual age, sex, and body height);
incident injurious falls over 6 years, from Hospital Discharge Diagnosis; and physical
and cognitive functioning at the baseline and at 3- and 6-year follow-ups by evaluating
walking speed, balance, chair stand, and Mini-Mental State Examination, respectively.
Results
Over the follow-up, 232 individuals experienced injurious falls. Cox models indicated
7% higher risk of falls per each 10th reduction in PEF SR-percentile. The risk of
injurious falls increased by more than twice for those who had PEF SR-percentile <10th
as for values of 80th-100th (hazard ratio = 2.31, 95% confidence interval: 1.41-3.76).
Physical deficits mediated 63% of the total effect of PEF on falls risk.
Conclusions and Implications
Our findings suggest that low PEF is associated with higher risk of injurious falls
in older adults, and most of this association is explained by balance or muscular
strength deficits.
Keywords
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Article info
Publication history
Published online: January 13, 2020
Footnotes
The SNAC-K study was supported by the Ministry of Health and Social Affairs, Sweden; the participating county councils and municipalities; and the Swedish Research Council (VR). In addition, study collaborators D.R., L.F., and A.K.W. were supported by specific grants from VR (grant nos. 2017-06088 and 521-2014-21-96) and the Swedish Research Council for Health,Working Life and Welfare (FORTE; grant nos. 2017-01768 and 2016-07175).
The authors declare no conflicts of interest.
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