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Age and Ageing Advance Access originally published online on July 9, 2009
Age and Ageing 2009 38(5):548-552; doi:10.1093/ageing/afp110
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© The Author 2009. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

The threshold for sensing airflow resistance during tidal breathing rises in old age: implications for elderly patients with obstructive airways diseases

Stephen C. Allen1, Michael Vassallo2 and Ahmed Khattab3

1 Medicine and Geriatrics, Royal Bournemouth Hospital, Castle Lane East, Bournemouth BH7 7DW, UK
2 Medicine and Geriatrics, Royal Bournemouth Hospital, Bournemouth, UK
3 Health and Social Care, Bournemouth University, Bournemouth, UK

Address correspondence to: S. C. Allen. Tel: (+44) 1202 704539; Fax: (+44) 1202 704542. Email: stephen.allen{at}rbch.nhs.uk

Objective: to determine whether the ability of elderly subjects to detect a rise in airflow resistance is attenuated in old age, and to measure the magnitude and variability of such a change.

Methods: we studied 124 healthy adults aged 20–86 years. Progressive external airflow resistance loading was used to measure the inspiratory and expiratory load detection thresholds (LDTs) during tidal breathing at rest.

Results: the mean inspiratory LDT rose from 4.00 (3.06 SD) kPa.s/L in the 20–39 age group to 6.51 (6.20) in the 40–64 age group (NS) and 29.10 (13.58) in the 65 + age group (P < 0.00001). The inspiratory LDT was significantly correlated with age, mainly due to the higher thresholds in people over the age of 65 (r = 0.7860, P < 0.00001), but did not correlate with age-corrected forced vital capacity or respiratory rate. Expiratory LDT values and correlations were very similar. Day-to-day variability in LDTs tended to be higher in older subjects.

Conclusion: the threshold for detecting external resistive loads during tidal breathing rises in old age. This appears to be a consequence of ageing processes rather than pathology, and might be a manifestation of a fall in proprioceptive acuity in elderly people. This finding has clinical implications for the self-management of asthma in old age. There is a need to conduct a similar study in patients with airways disease.

Keywords: airflow resistance sensing, age, asthma, respiratory proprioception, elderly

Received 5 January 2009; accepted in revised form 29 April 2009.


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