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Definition of Respiratory Sarcopenia With Peak Expiratory Flow Rate
Authors:Takeshi Kera  Hisashi Kawai  Hirohiko Hirano  Motonaga Kojima  Yutaka Watanabe  Keiko Motokawa  Yoshinori Fujiwara  Kazushige Ihara  Hunkyung Kim  Shuichi Obuchi
Affiliation:1. Department of Physical Therapy, Takasaki University of Health and Welfare, Gunma, Japan;2. Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan;3. Department of Dentistry and Oral Surgery, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan;4. Department of Physical Therapy, University of Tokyo Health Sciences, Tokyo, Japan;5. Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan;6. Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan;7. Department of Social Medicine, Hirosaki University School of Medicine, Aomori, Japan
Abstract:ObjectivesRespiratory muscle strength decreases with advancing age, and respiratory muscle dysfunction may indicate respiratory sarcopenia. However, there is no consensus regarding the definition of respiratory sarcopenia. We aimed to create a definition of respiratory sarcopenia based on the peak expiratory flow rate (PEFR).DesignCross-sectional study.Setting and participantsCommunity-based study including 681 community-dwelling older people.MethodsBody composition, spirometry, grip strength, and walking speed were measured. Participants reported comorbidities and long-term insurance certification. Conventional sarcopenia was defined using skeletal muscle mass, grip strength, and walking speed adjusted for the Japanese population. Receiver operating characteristic (ROC) curve analysis of the cut-off values of PEFR for conventional sarcopenia and long-term care insurance certification were performed for both sexes without airway obstruction. In the ROC curve analysis, potential cut-off values were lowest quartile, lowest quintiles, and the standard deviation of PEFR. Multiple logistic regression analysis was performed with respiratory sarcopenia as a dependent variable defined by each cut-off value and other variants as independent variables.ResultsThe ROC curve analysis for conventional sarcopenia and long-term care insurance certification showed significance for both sexes, and we determined cut-off values from those results. The multiple logistic regression model using PEFR values 1 standard deviation below the mean had the highest accuracy; thus, we accepted these cut-off values (4.40 L/s for men, 3.21 L/s for women) for the definition of respiratory sarcopenia.Conclusions/ImplicationsThe definition of respiratory sarcopenia based on PEFR was useful and correlated with conventional sarcopenia and long-term care insurance certification among community-dwelling older people. In this study, respiratory sarcopenia was determined by PEFR alone. Other parameters may need to be considered.
Keywords:Address correspondence to Shuichi Obuchi, PT, MS, PhD, 35-2 Sakae,-cho, Itabashi-Ku, Tokyo 173-0015, Japan.  Community-dwelling older people  peak expiratory flow rate  respiratory muscle  respiratory muscle sarcopenia  sarcopenia
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