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In older persons, sleep complaints in the form of insomnia and daytime drowsiness are highly prevalent and are associated with adverse outcomes. The underlying mechanisms are linked to age-related declines in physiology (normal aging) and age-related increases in disease prevalence (usual aging). This article describes how normal aging leads to(More)
BACKGROUND Among older persons, we previously endorsed a two-step spirometric definition of chronic obstructive pulmonary disease (COPD) that requires a ratio of forced expiratory volume in 1sec to forced vital capacity (FEV(1)/FVC) below .70, and an FEV(1) below the 5th or 10th standardized residual percentile ("SR-tile strategy"). OBJECTIVE To evaluate(More)
BACKGROUND Among older persons, the association between frailty and spirometry-confirmed respiratory impairment has not been evaluated yet. METHODS By using data on white participants aged 65 to 80 years (Cardiovascular Health Study, N=3578), we evaluated cross-sectional and longitudinal associations between frailty and respiratory impairment, including(More)
BACKGROUND The Lambda-Mu-Sigma (LMS) method calculates the lower limit of normal for spirometric measures of pulmonary function as the fifth percentile of the distribution of z scores, suitably accounting for age-related changes in pulmonary function. Extending prior work, and to assess whether the LMS method is clinically valid when evaluating respiratory(More)
The aim of the present study was to evaluate, among older persons, the association between respiratory impairment and hospitalisation for chronic obstructive pulmonary disease (COPD), based on spirometric Z-scores, i.e. the LMS (lambda, mu, sigma) method, and a competing risk approach. Using data on 3,563 white participants aged 65-80 yrs (from the(More)
OBJECTIVE To develop a more age-appropriate spirometric definition of chronic obstructive pulmonary disease (COPD) among older persons. METHODS Using data from the Third National Health and Nutrition Examination Survey (NHANES III), we developed a two-part spirometric definition of COPD in older persons, aged 65-80 years, that 1) determines a cut-point(More)
RATIONALE The Global Lung Initiative (GLI) provides age-appropriate criteria for establishing spirometric impairment, including mild, moderate, and severe chronic obstructive pulmonary disease (COPD) and restrictive pattern, but its association with respiratory-related phenotypes has not been evaluated. OBJECTIVES To evaluate respiratory-related(More)
Chronic obstructive pulmonary disease (COPD), a common disease in elderly patients, is characterized by high symptom burden, health care utilization, mortality, and unmet needs of patients and caregivers. Respiratory failure and dyspnea may be exacerbated by heart failure, pulmonary embolism, and anxiety; by medication effects; and by other conditions,(More)
Progressive neuromuscular symptoms years after recovery from acute paralytic poliomyelitis have been termed the PPS. We describe a 52-year-old man who contracted poliomyelitis at age 9 years who fully recovered and 33 years later developed progressive dyspnea. Neurologic evaluation revealed bilateral paralysis of the vocal cords, generalized weakness, and(More)