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Original Research |

Prediction Equations for Single-Breath Diffusing Capacity in Subjects Aged 65 to 85 YearsDiffusing Capacity of the Lung in Elderly Subjects

Francisco Garcia-Rio, PhD; Ali Dorgham, MD; Raul Galera, MD; Raquel Casitas, MD; Elizabet Martinez, MD; Rodolfo Alvarez-Sala, PhD; Jose M. Pino, PhD
Author and Funding Information

From the Servicio de Neumología (Drs Garcia-Rio, Galera, Casitas, Martinez, Alvarez-Sala, and Pino), Hospital Universitario La Paz, IdiPAZ; the Carburos Medica (Dr Dorgham); and the CIBER de Enfermedades Respiratorias-CIBERES (Dr Garcia-Rio), Madrid, Spain.

Correspondence to: Francisco Garcia-Rio, PhD, Alfredo Marquerie 11, izqda, 1° A, 28034-Madrid, Spain; e-mail: fgr01m@gmail.com

Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Funding/Support: This work was supported by Fondo de Investigación Sanitaria (99/0218) and NEUMOMADRID grants.


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.

Funding/Support: This work was supported by Fondo de Investigación Sanitaria (99/0218) and NEUMOMADRID grants.


Chest. 2012;142(1):175-184. doi:10.1378/chest.11-2021
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Background:  In senior subjects, diffusing capacity of the lung for carbon monoxide (Dlco) is interpreted using prediction equations derived from primarily younger adult populations. Our objectives were to provide reference equations for single-breath Dlco for a cohort of healthy, never-smoking, white, European adults between 65 and 85 years of age and to compare the predicted values of this sample with those from other studies involving middle-aged adults.

Methods:  Reference equations were derived from a randomly selected sample from the general population of 431 healthy never smoker subjects aged 65 to 85 years (262 women and 169 men). Spirometry, lung volume determinations by plethysmography, and single-breath Dlco (corrected for hemoglobin) were performed following the American Thoracic Society/European Respiratory Society guidelines. Reference values and lower and upper limits of normal were derived using a piecewise polynomial model.

Results:  In addition to age, our reference equations confirmed the height and body size dependence of Dlco and diffusing capacity for alveolar volume (Dlco/Va) in older subjects. Practically all of the reference values obtained by extrapolating reference equations of middle-aged adults underestimated the true diffusing capacity of the healthy elderly volunteers. Middle-aged reference equations underestimated Dlco by 2.1% to 22.3% in women and 2.8% to 37.8% in men. In addition, Dlco/Va was overestimated up to 18% and 39.8% in women and men, respectively, whereas other equations underestimated Dlco/Va up to 22.2% and 11.9% in women and men, respectively.

Conclusions:  These results underscore the importance of using prediction equations appropriate to the origin and age characteristics of the subjects being studied.

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