Spirometric obstruction and tobacco exposure among male Turkish nursing home residents

Gulistan BAHAT ÖZTÜRK , Timur Selcuk AKPINAR, Raim İLİAZ, Asli TUFAN , Fatih TUFAN, Zumrut BAHAT, Zuleyha KAYA, Esen KIYAN, Hilal ÖZKAYA, Esad KARIŞIK, Demet TEKİN, Nurullah YÜCEL, Nilgün EERTEN, Mehmet Akif KARAN



Abstract
Spirometric obstruction is a prevalent problem in older adults and related to life-style risk
factors. Symptoms related to chronic-obstructive-pulmonary-disease (COPD) are also prevalent
symptoms with diverse etiologies – not limited to pulmonary obstruction. Older adults
may have unrecognized airway obstruction due to functional limitations or symptoms
mis-attributed to age/other co-morbidities. Therefore, spirometric obstruction may clinically be
over/under diagnosed. Over last few decades, the burden of smoking-related diseases has
increased in older adults. Additional evidence regarding older adults is required. We aimed to
study frequency of spirometric obstruction, its over/under diagnosis and tobacco exposure in a
group of male nursing-home residents. For spirometric obstruction diagnosis, two different
thresholds [(fixed value: 0.70) versus (age-corrected value: 0.65 in residents465 years of age)]
were compared for better clinical practice. One hundred and three residents with 71.4 ± 6.3
years-of-age included. Spirometric obstruction prevalences were 39.8 and 29.1% with fixed and
age-corrected FEV1/FVC thresholds, respectively. Age-corrected FEV1/FVC threshold underdiagnosed
COPD in 1.9% while fixed threshold overdiagnosed spirometric obstruction in 8.7%.
Active smokers were 64.1%, ex-smokers 23.3% and non-smokers 12.6%. Our study suggests
high prevalences of spirometric obstruction and smoking in male nursing-home residents in
Turkey. We suggest the use of age-corrected FEV1/FVC threshold practicing better than the use
of fixed FEV1/FVC threshold in this patient group.

Key words:  Chronic obstructive pulmonary disease, diagnosis, older adults, smoking,