Prevalence and Correlates of Respiratory Symptoms and Disease in the Elderly: Predictors of Lung Diseases

We determined multivariate logistic regression models predicting affirmative answers to the questions “Have you ever had asthma (chronic bronchitis or emphysema) confirmed by a doctor?” (Table 5). As expected, asthma was very strongly associated with attacks of wheezing with dyspnea. Those with a history of asthma were 3.5 times more likely to have baseline airways obstruction detected by spirometry. Asthma was associated with fewer pack-years of smoking and less likely in Pittsburgh (clinic P).
A diagnosis of chronic bronchitis was independently associated with a low FEVi, current smoking of 20 cigarettes or more per day, increased body weight, and high school or college education (when compared with less education). When all of these factors were taken into consideration, women were twice as likely as men to have chronic bronchitis, and participants from Pittsburgh were significantly less likely.
A diagnosis of emphysema, as reported by 4.7 percent of our participants, was independently associated with a low FEVi, higher pack-years of smoking, lower body weight, and symptoms of attacks of wheezing and DOE. Elderly men were twice as likely as elderly women to have a diagnosis of emphysema, even when all of the above variables were taken into consideration in the model. buying antibiotics online

We were interested in the group of participants who had airflow limitation (obstruction) on spirometry, but who did not have a physician diagnosis of obstructive lung disease (asthma, chronic bronchitis, or emphysema). Obstruction was defined as the FEVi/FVC and the FEVi both below the lower limit of the normal range, based on our internally generated reference equations. Undiagnosed airways obstruction was more than five times as likely in current smokers and three times as likely in former smokers, compared with never smokers, and positively associated with pack-years of smoking.

Table 5—Predictors of Physician-Diagnosed Lung Diseases and Undiagnosed Airways Obstruction, Using Stepwise Logistic Models

OR Cl p Value
Asthma (ATS Q#20C)
Wheezing attacks 17 13-23 <0.001
Obstruction* 3.5 2.6-4.7 <0.001
Pack-years smoking 0.915 0.87-0.96 <0.001
Clinic P 0.58 0.40-0.84 0.004
Chronic bronchitis (ATS Q#18C)
Male gender 0.47 0.38-0.57 <0.001
InFEVi 0.14 0.09-0.22 <0.001
InFVC 2.6 1.5-4.5 <0.001
Smoked >1 pack per day 1.5 1.2-1.9 <0.001
Weight, +10 kg 1.06 <0.001
Clinic P 0.63 0.52-0.77 <0.001
College education 1.5 1.1-1.9 0.003
High school education 1.4 1.1-1.8 0.008
Emphysema (ATS Q#19C)
Male gender 2.2 1.5-3.4 <0.001
InFEVi 0.024 0.011-0.49 <0.001
InFVC 17 6-48 <0.001
Pack-years, +10 1.12 1.07-1.17 <0.001
Wheezing attacks 2.7 1.8-4.1 <0.001
Dyspnea, grade 3+ 2.4 1.7-3.5 <0.001
Weight, +10 kg 0.895 0.84-0.95 <0.001
Airways obstruction
Male gender 0.49 0.32-0.75 <0.001
Current smoker 5.5 3.5-8.8 <0.001
Former smoker 2.7 1.8-4.1 <0.001
Pack-years, +10 1.18 1.13-1.24 <0.001
Chronic cough 2.7 1.8-4.0 <0.001
Higher income 0.32 0.16-0.66 0.001
Height, +10 cm 1.25 1.01-1.55 0.043
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