Quality Control of Spirometry in the Elderly

We evaluated the outcome of the spirometry quality control program of the SA.R.A. multicenter project, the aim of which is the multidimensional assessment of asthma and COPD in the elderly ( ⩾ 65 yr). The factors determining this quality were also evaluated. The program was based on standardized procedures (ATS recommendations), performed by specifically trained and certified personnel; a fully-computerized spirometer with customized software was used for spirometry. A reference center made monthly controls. Overall, 638 cases and 984 controls were examined. Spirometric measurements were obtained in 607 cases and 912 controls; 508 and 747 tests with at least three acceptable curves were obt…

Evaluation of health outcomes in elderly patients with asthma and COPD using disease-specific and generic instruments: the Salute Respiratoria nell'Anziano (Sa.R.A.) Study.

To compare the effects of asthma and COPD on health status (HS) in elderly patients, and to assess the correlation between disease-specific and generic instruments assessing HS.Multicenter, cross-sectional, observational study.The Salute Respiratoria nell'Anziano (respiratory health in the elderly) Study network of outpatient departments.One hundred ninety-eight asthma patients and 230 COPD patientsor = 65 years old.HS was assessed by the Saint George's Respiratory Questionnaire (SGRQ) and five generic outcomes: Barthel's index, 6-min walk test, mini mental state examination, geriatric depression scale (GDS), and quality-of-sleep index. Independent correlates of SGRQ scores were assessed by…

Spirometry Reference Values for Women and Men Aged 65–85 Living in Southern Europe: The Effect of Health Outcomes

<i>Background:</i> Spirometry is more and more frequently used for the diagnosis of respiratory diseases in the elderly people. Unfortunately, reliable predictive values for the spirometric variables in the elderly are lacking. <i>Objectives:</i> Data obtained from 429 subjects participating in the multicenter Italian study SARA on respiratory health in the elderly were analyzed in order to derive reference values for spirometry in the age range of 65–85 years. The second aim of this study was to assess the influence of variables describing many dimensions of the health status on the prediction of spirometric variables in that age range. <i>Methods:</i> S…

From Global Initiative for Chronic Obstructive Lung Disease (GOLD) Guidelines to Current Clinical Practice

Background: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines have been promulgated to improve the management of chronic obstructive pulmonary disorder (COPD). Objective: To evaluate the extent to which the current therapeutic approach to COPD conforms to GOLD guidelines. Methods: This was a multicentre observational study of elderly COPD patients enrolled for acute care in general medicine or geriatric wards in tertiary hospitals in Italy in April 2002. Our series consisted of 471 patients >64 years of age consecutively admitted for acute exacerbations of COPD to wards participating in the study. Data describing drugs used prior to exacerbation and prescribed at …

Aging and Disability Affect Misdiagnosis of COPD in Elderly Asthmatics

Study objectives: This study investigated to what extent a diagnosis of COPD is erroneously made or the disease remains unrecognized in elderly asthmatic patients, and identified factors leading to misdiagnosis and underdiagnosis of asthma in such patients. Design: A multicenter study involving 24 Italian pulmonary or geriatric institutions. Patients: One hundred twenty-eight asthmatic patients (98 women, 76.6%) aged 73 6.4 years (mean SD) were selected from the cohort of the Salute Respiratoria nell’Anziano (respiratory health in the elderly) study. Methods: All patients underwent a clinical evaluation that included clinical history and spirometry with a bronchodilator test. A diagnosis of…

Use of antibiotics in elderly patients with exacerbated COPD: the OLD-chronic obstructive pulmonary disease study

Evaluation of Health Outcomes in Elderly Patients With Asthma and COPD Using Disease-Specific and Generic Instruments

Abstract Objectives To compare the effects of asthma and COPD on health status (HS) in elderly patients, and to assess the correlation between disease-specific and generic instruments assessing HS. Design Multicenter, cross-sectional, observational study. Setting The Salute Respiratoria nell'Anziano (respiratory health in the elderly) Study network of outpatient departments. Patients One hundred ninety-eight asthma patients and 230 COPD patients ≥ 65 years old. Measurements HS was assessed by the Saint George's Respiratory Questionnaire (SGRQ) and five generic outcomes: Barthel's index, 6-min walk test, mini mental state examination, geriatric depression scale (GDS), and quality-of-sleep in…

Sleep disorders in the elderly with and without chronic airflow obstruction: the SARA study

Objectives: Our objectives were to test the hypothesis that, in the geriatric population, chronic airway obstruction is associated with a higher prevalence of sleep disturbances; to identify the main correlates of sleep disturbances, and to verify whether asthma and COPD patients have different patterns of sleep disturbances. Methods: The EPESE questionnaire was administered to 734 patients aged 65 years and over with asthma or chronic obstructive pulmonary disease (cases) and 1237 individuals of comparable age who were free of respiratory disease but not of other chronic conditions (controls). Four sleep disturbances were quantified: difficulty in falling asleep, nocturnal awakening, morni…

Mild to moderate chronic airways disease does not carry an excess risk of cognitive dysfunction

Whether chronic obstructive pulmonary disease (COPD) carries a risk of cognitive dysfunction prior to the onset of arterial hypoxemia is not known. Our objective was to assess both the prevalence and main correlates of subclinical cognitive dysfunction in older patients with non-hypoxemic COPD.Home-dwelling non-demented subjects over 64 years of age consecutively attending 24 outpatient Departments of Respiratory Medicine or Geriatrics because of COPD (N = 233), asthma (N = 203), non-obstructive bronchitis (N = 92) or chronic non-respiratory and non-dementing diseases (controls, N = 1080) underwent a multidimensional assessment. Cognitive status was assessed by the Mini-Mental State Examina…

Long-term effects of lercanidipine on the lipoprotein and apolipoprotein profile of patients with mild-to-moderate essential hypertension

Abstract The goal of this multicenter, randomized, double-masked, parallel- group study was to assess the effects of lercanidipine versus those of hydrochlorothiazide (HCTZ) on the lipoprotein and apolipoprotein profile of patients with mild-to-moderate essential hypertension. After a 2-week washout period, 52 patients (age range, 18 to 70 years) were randomly allocated to receive lercanidipine 10 mg (n = 26) or HCTZ 12.5 mg (n = 26) once a day for 24 weeks. In nonresponding patients, the dose was increased to 20 or 30 mg of lercanidipine once a day and to 25 or 37.5 mg of HCTZ once a day, after 4 and 8 weeks, respectively. To assess long-term effects, patients receiving lercanidipine enter…