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H. Ishida1, C. Kurozumi2, H. Matsumoto1, T. Suehiro1
1Kawasaki University of Medical Welfare, Department of Physical Therapy, Kurashiki, Japan, 2Kawasaki University of Medical Welfare, Department of Occupational Therapy, Kurashiki, Japan
Background: The fifth leading cause of death in Japan is pneumonia. Expiratory flow expels foreign substances from the trachea, thus minimizing the risk of aspiration pneumonia. Respiratory function declines with aging, and respiratory muscle dysfunction may indicate respiratory sarcopenia. Therefore, it is important to think about expiratory muscles of the elderly individuals to prevent the incidence of aspiration pneumonia. On the other hand, literature has shown that low bone mineral density could be a risk factor of mortality in elderly women. However, it was not possible to detect the underlying mechanism of the mortality associated with low bone mineral density.
Purpose: The aim of this study was to examine the relationships between peak expiratory flow rate, bone density, and abdominal muscle thickness in elderly women.
Methods: This study used a cross-sectional design. Forty-two community-dwelling elderly women able to perform activities of daily living involving walking independently with or without walking aids participated in this study. The median (first–third quartile) of participants’ ages, heights, weights, and body mass index were 85 (81–88) years, 149.3 (144.9–152.5) cm, 50.5 (46.0–55.0) kg, and 23.1 (20.9–24.9) kg/m2, respectively. Participants were recruited from the Outpatient Rehabilitation Center of the Shukumo Clinic in Okayama, Japan. Respiration function was assessed by forced vital capacity, which was measured using a spirometer (HI-801, Chest Co. Ltd., Tokyo, Japan). Airway obstruction was deemed to be present when the FEV1.0% (forced expiratory volume in 1 second / forced vital capacity × 100) was less than 70 %. The speed of sound of the right calcaneus was measured using an ultrasound bone densitometer (CM-300, Furuno Electric Co. Ltd., Hyogo, Japan). B-mode (Noblus, Hitachi Ltd., Tokyo, Japan) with a 18-5 MHz linear probe (L64) was used to perform ultrasound imaging of the right rectus abdominis, external oblique, internal oblique, and transverse abdominis muscles. The relationship between peak expiratory flow rate and the other obtained values were investigated using Spearman’s correlation coefficient (p<0.05).
Results: All of the subjects’ FEV1.0% was within the normal range. The peak expiratory flow rate showed a significant positive correlation with calcaneus bone density (r=0.357, p=0.020) and external oblique muscle thickness (r=0.339, p=0.028).
Conclusion(s): Calcaneus bone loss and abdominal external oblique muscle atrophy, in accordance with low peak expiratory flow rate, were observed in community-dwelling elderly women. A decrease in the frequency to perform physical activities, including movement of trunk rotation, might be associated with low peak expiratory flow rate, bone loss, and external oblique muscle atrophy. However, the exact mechanism of the associations between respiratory function and bone density and abdominal muscle thickness is unclear.
Implications: In the elderly women whom the bone density decreases, there may be little spare ability to expectorate an aspiration thing by fast expiration.
Funding, acknowledgements: None.
Keywords: peak expiratory flow rate, bone density, abdominal muscle thickness
Topic: Health promotion & wellbeing/healthy ageing/physical activity
Did this work require ethics approval? Yes
Institution: Kawasaki University of Medical Welfare
Committee: The Ethics Committee of the Kawasaki University of Medical Welfare
Ethics number: 19-025
All authors, affiliations and abstracts have been published as submitted.
