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Employing the Forced Oscillation Technique for the Assessment of Respiratory Mechanics in Adults

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Reporting peak expiratory flow in older persons.

Carlos A Vaz Fragoso¹, Evelyne A Gahbauer, Peter H Van Ness

¹Department of Internal Medicine, Yale University School of Medicine, 333 Cedar Street, P.O. Box 208025, New Haven, CT 06250-8025, USA. carlos.fragoso@ynhh.org

The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences

|October 9, 2007

Summary

Standardized residual (SR) percentile offers a more accurate way to interpret peak expiratory flow (PEF) in older adults. This method better reflects health status and identifies risks at appropriate levels compared to percent predicted (%predicted).

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Area of Science:

Gerontology
Pulmonary Medicine
Biostatistics

Background:

Peak expiratory flow (PEF) is a predictor of health outcomes in older adults.
Current methods for reporting PEF, such as percent predicted (%predicted), may lack validity in this population.
The clinical utility of PEF is uncertain due to potential issues with existing reporting strategies.

Purpose of the Study:

To determine the frequency distribution of PEF using both %predicted and standardized residual (SR) percentile methods.
To evaluate the relationship between these two PEF metrics and health status in older individuals.
To assess the validity of different PEF reporting strategies for risk stratification in the elderly.

Main Methods:

Study included 754 community-dwelling participants aged 70 years and older.
Data collected included information on chronic conditions, frailty indicators, and PEF measurements.
PEF was analyzed using both %predicted and SR percentile calculations.

Main Results:

A significant proportion of participants (77.1%) exhibited frailty indicators.
PEF ≥ 80% predicted was observed in 67.5%, while PEF ≥ 80th SR percentile was only in 15.9%.
%predicted identified health risk at normal levels (80-100%), whereas SR percentile indicated risk only at severely reduced levels (<50th).

Conclusions:

SR percentile provides a frequency distribution more aligned with the characteristics of an elderly cohort.
SR percentile establishes health risk at more appropriate thresholds for reduced PEF in older adults.
Further longitudinal studies using SR percentile are needed to validate PEF as a risk assessment tool in the elderly.