Population reference equations for handheld peak expiratory flow in older U.S. adults

Area of Science:

• Gerontology
• Respiratory Medicine
• Epidemiology

Background:

• Peak expiratory flow (PEF) is a key respiratory metric for older adults.
• Existing PEF prediction equations lack validation in populations aged 80 and older.
• The National Health and Aging Trends Study (NHATS) provides a large dataset for developing new PEF equations.

Purpose of the Study:

• To develop and validate sex-specific PEF prediction equations for older adults using NHATS data.
• To compare newly developed PEF equations with existing spirometry-based equations (NHANES).

Main Methods:

• Utilized a healthy subsample (N=1740) from the NHATS 2011 cohort.
• Generated sex-specific PEF reference equations using height and age.
• Validated equations against the NHATS 2015 cohort and compared them to NHANES spirometry equations.

Main Results:

• NHATS 2011 PEF equations showed no significant difference between measured and predicted values in the NHATS 2015 cohort.
• NHANES equations overestimated handheld PEF measurements in the NHATS 2015 cohort.
• Demonstrated comparability between handheld PEF equations and spirometry-based equations.

Conclusions:

• PEF reference equations derived from handheld meters are comparable to spirometry equations in older adults.
• New equations are suitable for use in older populations, including those traditionally undersampled.
• Handheld PEF offers a low-cost, easily obtainable measure for assessing respiratory health in the elderly.