Prevalence and Correlates of Respiratory Symptoms and Disease in the Elderly: Bivariate Relationships

Hay fever was reported by about twice as many smoking women as smoking men (15 percent vs 7 percent). As expected, elderly men and women who were current cigarette smokers reported a physician diagnosis of smoking-related lung disease more frequently than did never smokers. Almost three times as many male current smokers reported a diagnosis of emphysema than did female smokers (5 percent vs 14 percent).
Almost all of the major respiratory symptoms and smoking-related lung diseases were highly correlated with each other and with airways obstruction as determined by spirometry. Table 3 presents the odds ratios for any two of these categorical variables coexisting. For instance, the odds of an elderly person in the CHS cohort with a physician diagnosis of emphysema also having chronic bronchitis is about seven times the odds for a person without emphysema. Participants with emphysema are seven times as likely to have attacks of wheezing with dyspnea than are other participants. An elderly person with asthma is five times as likely to have airways obstruction than are other participants buy zyrtec online. The odds ratios were similar for men and women and across CHS age categories; therefore, the odds ratios are not corrected for these variables.
Independent predictors of an affirmative answer to the question “Have you ever had an attack of wheezing that has made you feel short of breath?” (ATS question 11A), as reported by 8 percent of our participants, included a low FEVi, heart failure, coronary heart disease, and a large waist size (cen-tripedal obesity) (Table 4). Wheezing attacks were also more likely in those with less education and less likely in those attending the Pittsburgh clinic (data not shown), and were not independently associated with gender or smoking status.

Table 3—Odds Ratios of Concurrent Pulmonary Symptoms, Pulmonary Diagnoses, or Airways Obstruction

Risk Factor
ChrBr Asthma Cough Phlegm Wheeze Dysp Obstr
Emphysema 7.15 4.65 4.39 4.59 7.25 5.79 9.17
ChrBr 6.72 4.27 3.60 8.04 3.02 3.25
Asthma (1.60) 2.32 20.3 2.74 4.92
Cough 14.3 4.98 3.73 3.52
Phlegm 4.21 3.34 3.29
Wheeze 7.58 4.79
Dyspnea 2.94

Table 4—Correlates of Major Respiratory Symptoms Using Stepwise Logistic Models

OR Cl p Value
Wheezing attacks (ATS Q#11A)
InFEVi 0.14 0.09-0.22 <0.001
InFVC 2.6 1.5-4.5 <0.001
Heart failure 2.5 1.5-4.2 <0.001
Coronary heart disease 1.7 1.3-2.2 <0.001
Waist size, +10 cm 1.25 1.14-1.37 <0.001
Chronic cough (ATS Q#7E)
InFEVi 0.10 0.063-0.17 <0.001
InFVC 4.8 2.6-9.1 <0.001
Current smoking 3.6 2.8-4.6 <0.001
Chronic phlegm (ATS Q#8E)
InFEVi 0.11 0.07-0.18 <0.001
InFVC 5.1 2.6-10 <0.001
Current smoking 2.4 1.9-3.0 <0.001
Male gender 1.7 1.4-2.2 <0.001
Smoked >1 pack per day 1.5 1.1-2.0 0.006
Coronary heart disease 1.3 1.1-1.6 0.005
Dyspnea, grade 3+ (ATS Q#13C)
Heart failure 3.7 2.5-5.5 <0.001
Coronary heart disease 3.2 2.6-3.9 <0.001
Emphysema 3.0 2.1-4.4 <0.001
InFEVi 0.11 0.07-0.18 <0.001
Chronic bronchitis 1.6 1.3-2.0 <0.001
Age, +10 yr 1.39 1.16-1.64 <0.001
Waist size, +10 cm 1.22 1.09-1.37 <0.001
Hip size, +10 cm 1.27 1.10-1.47 <0.001
Pack-years, +10 1.05 1.02-1.09 0.003
Asthma 1.6 1.2-2.2 0.003
InFVC 0.44 0.23-0.84 0.012
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