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Chronic obstructive pulmonary disease
Is age-related decline in lean mass and physical function accelerated by obstructive lung disease or smoking?
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  1. Bram van den Borst1,2,
  2. Annemarie Koster2,
  3. Binbing Yu2,
  4. Harry R Gosker1,
  5. Bernd Meibohm3,
  6. Douglas C Bauer4,
  7. Stephen B Kritchevsky5,
  8. Yongmei Liu6,
  9. Anne B Newman7,
  10. Tamara B Harris2,
  11. Annemie M W J Schols1,
  12. For the Health ABC Study
  1. 1Department of Respiratory Medicine, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
  2. 2Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, Maryland, USA
  3. 3Department of Pharmaceutical Sciences, University of Tennessee Health Science Center, Memphis, Tennessee, USA
  4. 4Division of General Internal Medicine, University of California, San Francisco, California, USA
  5. 5Sticht Center on Aging, Wake Forest University, Winston-Salem, North Carolina, USA
  6. 6Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
  7. 7Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  1. Correspondence to Dr Bram van den Borst, Department of Respiratory Medicine, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center+, P O Box 616, 6200 MD Maastricht, The Netherlands; b.vdborst{at}maastrichtuniversity.nl

Abstract

Background and aims Cross-sectional studies suggest that obstructive lung disease (OLD) and smoking affect lean mass and mobility. A study was undertaken to investigate whether OLD and smoking accelerate the ageing-related decline in lean mass and physical functioning.

Methods 260 patients with OLD (mean±SD forced expiratory volume in 1 s (FEV1) 63±18% predicted), 157 smoking controls (FEV1 95±16% predicted), 866 former-smoking controls (FEV1 100±16% predicted) and 891 never-smoking controls (FEV1 104±17% predicted) participating in the Health, Aging and Body Composition (ABC) Study were studied. At baseline the mean age was 74±3 years and participants reported no functional limitations. Baseline and 7-year longitudinal data of body composition (by dual-energy x-ray absorptiometry), muscle strength (by hand and leg dynamometry) and Short Physical Performance Battery (SPPB) were investigated.

Results Compared with never-smoking controls, patients with OLD and smoking controls had a significantly lower weight, fat mass, lean mass and bone mineral content (BMC) at baseline (p<0.05). While the loss of weight, fat mass, lean mass and strength was comparable between patients with OLD and never-smoking controls, the SPPB declined 0.12 points/year faster in men with OLD (p=0.01) and BMC declined 4 g/year faster in women with OLD (p=0.02). In smoking controls only lean mass declined 0.1 kg/year faster in women (p=0.03) and BMC 8 g/year faster in men (p=0.02) compared with never-smoking controls.

Conclusions Initially well-functioning older adults with mild-to-moderate OLD and smokers without OLD have a comparable compromised baseline profile of body composition and physical functioning, while 7-year longitudinal trajectories are to a large extent comparable to those observed in never-smokers without OLD. This suggests a common insult earlier in life related to smoking.

  • Obstructive lung Disease
  • body composition
  • ageing
  • COPD mechanisms
  • COPD epidemiology
  • COPD pathology
  • emphysema
  • lung physiology
  • oxidative stress
  • pulmonary rehabilitation
  • respiratory muscles
  • systemic disease and lungs
  • asthma
  • asthma mechanisms
  • COPD exacerbations
  • cough/mechanisms/pharmacology
  • exercise

https://doi.org/10.1136/thoraxjnl-2011-200010

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    Footnotes

    • See Editorial, p 933

    • Funding This study was supported by National Institute on Aging contracts N01-AG-6-2101, N01-AG-6-2103 and N01-AG-6-2106 and National Heart Lung and Blood Institute grant R01-HL-74104. This research was supported (in part) by the Intramural Research Program of the NIH, National Institute on Aging. This study was performed within the framework of the Dutch Top Institute Pharma project T1-201, The Netherlands.

    • Correction notice This article has been corrected since it was published Online First. Figures 3 and 4 had incorrect footnote symbols.

    • Competing interests None.

    • Patient consent Obtained.

    • Ethics approval The Health ABC Study protocol was approved by the Institutional Review Boards of the clinical sites in Pittsburgh, Pennsylvania and Memphis, Tennessee.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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