ASSESSMENT OF VENTILATORY FUNCTION IN THE ELDERLY

Objectives: Many elderly subjects are at risk of respiratory failure d ue fo effect of age on ventilatory system and the deleterious. effects of toxins and respiratory diseases. As spirometry is the main techniq ue currently used to detect altered ventilatory function we first used this method in very elderly subjects then compared the results with c linical measurements of chest and abdominal ampliation. Methods: Among 65 subjects over 75 years of age, with no cardiorespiratory or neurop sychologic impairment and who had undergone spirometry and chest and a bdominal ampliation measurements in 1991, 24 were re-examined in 1994 using exactly the same techniques. Forced vital capacity and maximum e xpiratory volume/second were measured at the patient's home with a pre viously calibrated spirometer. Ah tests were run according to the reco mmendations of the European Respiratory Society. Variations in upper c hest, lower chest and abdominal circumferences were also recorded. Res ults: Mean age of the subjects was 84.1 +/- 3.7 years and all spiromet ric tests were reproductible within a given measurement session. There was no significant difference for forced vital capacity or for maximu m expiratory volume/second between the 1991 and the 1994 values with v ariations of 2.1. +/- 0.4 and 9.4 +/- 3.4% respectively. Four of the 2 4 initially asymptomatic subjects had signs of obstruction which resol ved in 2 with the salbutamol and/or ipratropium bromide. The correlati ons between spirometric data and chest and abdominal ampliations were significative. Conclusions: Spirometry can be an effective tool in eld erly patients. In addition to frequent discovery of reversible bronchi al obstruction (7 to 41% according to the series), it can be used to s creen for reduced ventilatory ''reserve'' Chest ampliations measures a lso appear to be simple means of determining which subjects could bene fit from physical therapy aimed at improving chest and abdominal muscu lature.