Distúrbios ventilatórios obstrutivo e restritivo aumentam o risco de incidência de dinapenia em pessoas com mais de 50 anos de idade?

Abstract

The decline in lung function and neuromuscular strength (dynapenia) occurs during aging. Cross-sectional studies have demonstrated an association between the reduction in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) with a decrease in neuromuscular strength. However, no longitudinal study has been carried out to date. Objective: To analyze whether obstructive or restrictive ventilation disorders are risk factors for the incidence of dynapenia. Methods: Longitudinal study involving 4,975 participants from the English Longitudinal Study of Aging (ELSA) aged 50 or over, without dynapenia at baseline, and followed for eight years. Lung function was assessed by spirometry (predicted percentage) and participants were classified as: without ventilatory disorder (FEV1 ≥ 80%, FVC ≥ 80% and FEV1/FVC ratio ≥ 70%), with obstructive ventilatory disorder (FEV1 < 80% and FEV1/FVC < 70% with normal FVC or < 80%) or with restrictive ventilation disorder (FVC < 80% and FEV1/FVC > 70% with normal FEV1 or < 80%). The incidence of dynapenia was defined by handgrip strength < 26 kg for men and < 16 kg for women during the eight years of follow-up. Poisson regression models were adjusted for sociodemographic, behavioral, and clinical characteristics. Results: The incidence density of dynapenia was 14.2/1000 person-years (95% CI 12.6 – 15.9) in those without ventilatory disorders, 25.1/1000 person-years (95% CI 21.2 – 29.7) in those with restrictive ventilation disorder and 36.6/1000 people/year (95% CI 23.8 – 56.1) in those with obstructive ventilation disorder. Having an obstructive ventilation disorder increased the risk of developing dynapenia by 62% (IRR: 1.62; 95% CI 1.09 – 2.41). Already having a restrictive ventilation disorder increased the risk by 37% (IRR: 1.37; 95% CI 1.13 – 1.64). Conclusion: Obstructive and restrictive ventilation disorders are risk factors for the higher incidence of dynapenia in people over 50 years of age. These results highlight the importance of monitoring lung function to preserve neuromuscular strength and respiratory health as you age.