Background
There is an increasing awareness that asthma and COPD are very frequent in the elderly population, although in a large number of cases they are underdiagnosed and undertreated. The project SA.R.A. is the first Italian project aimed at stimulating and organising the research on various aspects of obstructive pulmonary diseases in the elderly (>65 years). Its mainstay is a close collaboration and interchange between specialists of pulmonary and chest medicine.
Aims of the current studies
To evaluate health related quality of life in elderly with and without obtructive pulmonary diseases by comparing generic and disease-specific measure of outcome.
To evaluate the capability of elderly to perform high quality spirometry in agreement with ATS 1994 criteria, and to establish the factors determining acceptability and reprobucibility of tests. To produce reference values for alderly people of Italian descent and to identify the effects of life -time smoking exposure on spirometric values. To define protocols of diagnosis and tratment in elderly with obstructive pulmonary diseases.
Methods
24 Italian pulmonary and geriatric institutions are participating in the Project.
Timetable: 1996-1998 Cross sectional case control study
1999-2001 Longitudinal follow-up
Cases= outpatients with previous diagnosis of asthma or COPD or with signs and symptoms compatible with either diagnosis consecutively attending the participating Institutions.
Controls: outpatients consecutively attending the institutions who did not have a previous diagnosis of asthma or COPD nor signs and symptoms compatible with either diagnosis.
Components of multimedial assessment
- Sociodemographic characteristics: age, sex, occupation, living conditions, educational level.
- SSmoking habit
- SQuality of Sleep: EPESE questionnaire
- SAnthropometric data: weight, height, waist and hip circumferences, occiput-wall distance, length of the thigh according to standardised procedures.
- SCognitive function: Mini Mental State Examination (MMSE)
- SAffective Status: short form of Geriatric Depression Scale (GDS)
- SPhysical performance: scales of Barthel, Nagi, Rosow-Breslau. Six minute walking test.
- SComorbidity: codified according to the Anatomical, Therapeuric and Chemical codes, 9th version.
- SDisease-related quality of life: Saint George's Respiratory Questionnaire.
Spirometry
Participating centers were provided with an identical fully computerized water sealed Stead-Wells spirometer (Baires System, Biomedin, Padua, Italy) which fulfils the ATS 1994 recommendations. Spirometry with bronchodilator test was performed according to ATS 1994 recommendations.
