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Interdependence of physical inactivity, loss of muscle mass and low dietary intake: Extrapulmonary manifestations in older chronic obstructive pulmonary disease patients

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Geriatrics and Gerontology International

Published online on


Aim Extrapulmonary manifestations, such as reductions in skeletal muscle and physical inactivity, are important clinical features of patients with chronic obstructive pulmonary disease (COPD), and might depend on the severity of COPD. As it is still unclear whether the relationship between muscle loss and physical inactivity is dominated by a disease‐specific relationship or caused by patient factors, including physiological aging, we aimed to investigate the pulmonary or extrapulmonary factors associated with physical inactivity among older COPD patients. Methods A total of 38 older male COPD patients (aged ≥65 years) were enrolled, and were evaluated cross‐sectionally. Skeletal muscle mass was measured using bioelectrical impedance, and physical activity and energy intake were recorded for 2 weeks using a pedometer and diary. Results Daily step counts were successfully evaluated in 28 participants (mean forced expiratory volume in 1 s [%predicted; %FEV1]; 49.5%), and ranged widely. The mean step counts was 5166 steps/day, and found to have a significant relationship with dyspnea (r = −0.46), diffusing capacity (r = 0.47), %FEV1 (r = 0.44), skeletal muscle index (r = 0.59) and total dietary intake (r = 0.47), but not with age (P = 0.14). A stepwise multivariate analysis showed that the skeletal muscle index (β = 0.50) and total dietary intake (β = 0.35) were significant determinants of the daily step count (R2 = 0.46, p < 0.01). Conclusions Although various pulmonary factors are associated with daily physical activity, skeletal muscle mass and dietary intake are more closely correlated with physical activity in COPD patients. Because physical inactivity might be the strongest predictor of prognosis, the present results suggest that a comprehensive treatment strategy must be considered for older COPD patients to improve their extrapulmonary manifestations and pulmonary dysfunction. Geriatr Gerontol Int 2017; ••: ••–••.