Characteristics associated with rapid decline in forced expiratory volume

Area of Science:

• Pulmonary Medicine
• Epidemiology
• Gerontology

Background:

• Cigarette smoking is a known risk factor for accelerated pulmonary function decline.
• The influence of other lifestyle and biologic factors on lung function decline is less understood.
• Identifying individuals at risk for rapid decline is crucial for targeted interventions.

Purpose of the Study:

• To examine characteristics associated with rapid decline in forced expiratory volume in 1-sec (FEV1) among Japanese-American men.
• To identify predictors of accelerated pulmonary function decline beyond smoking.
• To inform potential interventions for high-risk populations.

Main Methods:

• Longitudinal study of 4451 Japanese-American men from the Honolulu Heart Program (aged 45-68 at baseline).
• Calculation of average annual FEV1 decline rates using within-person regression over a 6-year period.
• Logistic regression analysis to compare lifestyle and biologic factors across FEV1 decline categories (rapid, moderate, slow), adjusted for age and other covariates.

Main Results:

• Continued smoking, higher cigarette pack-years, wheezing, coronary heart disease, alcohol intake, and reduced subscapular skinfold were significantly associated with rapid FEV1 decline.
• Among continuous smokers, cigarette pack-years, wheezing, and reduced subscapular skinfold were independent predictors.
• Among never smokers, lower educational attainment predicted rapid FEV1 decline, with subscapular skinfold approaching significance.

Conclusions:

• Factors beyond smoking, including wheezing, coronary heart disease, alcohol consumption, and body composition, contribute to accelerated pulmonary function decline.
• Lower education is a risk factor for rapid lung function decline in non-smokers.
• These findings help identify individuals at high risk for pulmonary function decline, enabling targeted preventive strategies.