{"title":"Baseline and longitudinal changes in peak expiratory flow rate as predictors of sarcopenia in older adults: A 4-year cohort study","authors":"Hui Qian , Qifeng Chen , Kangkang Chen","doi":"10.1016/j.jnha.2025.100640","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>Peak expiratory flow rate (PEFR) is a cheap and simple tool for assessing airway patency and respiratory muscle strength. So far, the impact of PEFR, particularly its longitudinal changes, on the prevalence and incidence of sarcopenia remains underexplored. Therefore, we conducted a cross-sectional and longitudinal study to address this gap.</div></div><div><h3>Methods</h3><div>We analyzed data from the China Health and Retirement Longitudinal Study (CHARLS). A total of 5,280 older adults were selected as a cohort in 2011, of whom 3,686 were confirmed sarcopenia-free at baseline and followed through 2015. Longitudinal changes in PEFR were measured in 2011 and 2013, with complete paired data available for 2,904 subjects. Sarcopenia was diagnosed according to the 2019 Asian Working Group for Sarcopenia (AWGS). Multivariable logistic regression and discrete-time proportional hazards models were used to assess associations between baseline PEFR, 2-year PEFR changes, and sarcopenia risk, adjusting for potential confounders.</div></div><div><h3>Results</h3><div>A 1-standard deviation (SD) decrease in baseline PEFR was associated with 56% higher odds of prevalent sarcopenia (OR = 1.56, 95% CI = 1.38−1.75), and PEFR (% predicted) <80% with 93% higher odds (OR = 1.93, 95% CI = 1.49–2.50). Over the 4-year follow-up, these reductions were linked to increased risk of incident sarcopenia (HR = 1.26, 95% CI = 1.13−1.40, and HR = 1.47, 95% CI = 1.17−1.84, respectively). A decline from PEFR (% predicted) ≥80% to <80% was associated with 120% higher odds (OR = 2.20, 95% CI = 1.31−3.71), while improvement from <80% to ≥80% was linked to 30% lower odds (OR = 0.70, 95% CI = 0.50−0.96).</div></div><div><h3>Conclusions</h3><div>Lower baseline PEFR and its longitudinal decline were associated with increased risk of sarcopenia, while upward changes were linked to lower risk. These findings suggest that PEFR may serve as a practical early marker for identifying older adults at elevated risk of sarcopenia.</div></div>","PeriodicalId":54778,"journal":{"name":"Journal of Nutrition Health & Aging","volume":"29 9","pages":"Article 100640"},"PeriodicalIF":4.0000,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Nutrition Health & Aging","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1279770725001654","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective
Peak expiratory flow rate (PEFR) is a cheap and simple tool for assessing airway patency and respiratory muscle strength. So far, the impact of PEFR, particularly its longitudinal changes, on the prevalence and incidence of sarcopenia remains underexplored. Therefore, we conducted a cross-sectional and longitudinal study to address this gap.
Methods
We analyzed data from the China Health and Retirement Longitudinal Study (CHARLS). A total of 5,280 older adults were selected as a cohort in 2011, of whom 3,686 were confirmed sarcopenia-free at baseline and followed through 2015. Longitudinal changes in PEFR were measured in 2011 and 2013, with complete paired data available for 2,904 subjects. Sarcopenia was diagnosed according to the 2019 Asian Working Group for Sarcopenia (AWGS). Multivariable logistic regression and discrete-time proportional hazards models were used to assess associations between baseline PEFR, 2-year PEFR changes, and sarcopenia risk, adjusting for potential confounders.
Results
A 1-standard deviation (SD) decrease in baseline PEFR was associated with 56% higher odds of prevalent sarcopenia (OR = 1.56, 95% CI = 1.38−1.75), and PEFR (% predicted) <80% with 93% higher odds (OR = 1.93, 95% CI = 1.49–2.50). Over the 4-year follow-up, these reductions were linked to increased risk of incident sarcopenia (HR = 1.26, 95% CI = 1.13−1.40, and HR = 1.47, 95% CI = 1.17−1.84, respectively). A decline from PEFR (% predicted) ≥80% to <80% was associated with 120% higher odds (OR = 2.20, 95% CI = 1.31−3.71), while improvement from <80% to ≥80% was linked to 30% lower odds (OR = 0.70, 95% CI = 0.50−0.96).
Conclusions
Lower baseline PEFR and its longitudinal decline were associated with increased risk of sarcopenia, while upward changes were linked to lower risk. These findings suggest that PEFR may serve as a practical early marker for identifying older adults at elevated risk of sarcopenia.
期刊介绍:
There is increasing scientific and clinical interest in the interactions of nutrition and health as part of the aging process. This interest is due to the important role that nutrition plays throughout the life span. This role affects the growth and development of the body during childhood, affects the risk of acute and chronic diseases, the maintenance of physiological processes and the biological process of aging. A major aim of "The Journal of Nutrition, Health & Aging" is to contribute to the improvement of knowledge regarding the relationships between nutrition and the aging process from birth to old age.