Abstract
BackgroundExtensive research has investigated the association between age changes in various domains, including lung function and motor function. However, a few analyses have tested models that incorporate bidirectional longitudinal influences between lung and motor function to test the temporal chain of events in the disability process. Dual change score models (DCSM) assist with identification of leading indicators of change by leveraging longitudinal data to examine the extent to which changes in one variable influence subsequent changes in a second variable, and vice versa.AimsThe purpose of the current-analysis study was to apply DCSM to data from the Swedish Adoption/Twin Study of ageing to examine the nature of the longitudinal relationship between motor functioning and lung function.MethodsThree motor functioning factors were created from 20 performance measures, including measures of balance, flexibility, and fine motor skills. Peak expiratory flow measured lung function. Participants were 829 adults aged 50–88 at the first of 9 waves of testing covering a 27-year follow-up period; 80% participated in at least three waves.ResultsModel comparisons indicated that decline in lung function preceded and contributed to subsequent decline in motor function.DiscussionCombined with previous results, these results suggest that declining lung function results in increasing difficulties in motor function, which contribute to subsequent declines in multiple domains.ConclusionUnderstanding the cascade of events that can lead to dependence can help in the development of interventions targeted early in the disablement process.
Highlights
Documented increases in lifespan can translate to an intensified challenge to minimize years lived with morbidity and dependence, and to maximize quality of the additional years of life [1, 2]
To systematically test the chain of events predicted by the disablement process, dual change score models were used to test the temporal relationships between lung function and motor function in longitudinal data
Comparison of models incorporating influences from lung function to subsequent motor function and from motor function to subsequent lung function indicated clearly that the chain of events moved in one direction: reduction in lung function contributes to subsequent increases in difficulties in motor function
Summary
Documented increases in lifespan can translate to an intensified challenge to minimize years lived with morbidity and dependence, and to maximize quality of the additional years of life [1, 2]. Physical functioning and cognitive functioning are essential to the maintenance of independence in older individuals, the ability to remain mobile [3]. Mobility measures such as balance and gait have been shown to predict the onset of difficulties with activities of daily living that are foundational to independent living [4, 5]. Extensive research has investigated the association between age changes in various domains, including lung function and motor function. A few analyses have tested models that incorporate bidirectional longitudinal influences between lung and motor function to test the temporal chain of events in the disability process. Conclusion Understanding the cascade of events that can lead to dependence can help in the development of interventions targeted early in the disablement process
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