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Cited by 284Chronic Obstructive Pulmonary Disease (COPD) ResearchSmoking Behavior and CessationAsthma and respiratory diseases

Decline of FEV1 by age and smoking status: facts, figures, and fallacies

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Kerstjens, H. A., Rijcken, B., Schouten, J. P., Postma, D. S.·1997·Thorax
DOI 10.1136/thx.52.9.820PMC PMC1758654
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Abstract

Assessment of pulmonary function testing plays as well as in patient based research and in epidemiological studies of healthy subjects, and a central role in everyday practice of the pultherefore the items discussed will be mainly monary physician.New patients are diagnosed centred around the FEV 1 .and graded in severity on the basis of results from these tests, and the course of the disease in previously diagnosed patients is judged with General course of FEV 1 over time the help of lung function measurements. TheThere is still considerable debate over the shape use of pulmonary function tests for these purof lung function increase and decline during poses requires a concept of what constitutes life.During childhood and adolescence there both a normal level and a normal decline and, is naturally a rise in lung function, the exact consequently, an unusually low level and acshape of which is beyond the scope of this celerated decline.The concept of a normal paper. 1 For the period early in adult life, differlevel is perceived to be fairly straightforward ent shapes have been suggested.Although some and is routinely deducted from some set of authors have taken the decline in lung function reference values.The population selection of to start at 15-20 years of age, 2 3 others have the reference equations used is taken to be found that the FEV 1 continues to rise to the sufficiently representative of the patient under age of 25 years, [4][5][6] or even into the fourth Department of study.In this review the problems associated Pulmonology decade. 1 7 It is probably fair to say that in with this assumption will be discussed and the and Department of healthy individuals there is a plateau phase in Epidemiology, cut off values between normal and abnormal early adulthood in which there is little or no University of examined.The same reference equations are change in FEV 1 . 1 6 8 The European Community Groningen, often employed for the judgement of normal Groningen, for Coal and Steel stipulates that no change The Netherlands decline, assuming that the coefficient for age occurs between the ages of 18 to 25 and an H A M Kerstjens adequately represents decline in individuals.age of 25 years should be entered into the B RijckenThis approach, however, can be rather inregression equation for this whole age range.9 J P Schouten D S Postma adequate and this will be reviewed.Ad-After this plateau FEV 1 starts to decrease, with ditionally, special reference will be given to the newer studies that exclude smokers more Correspondence to: Dr H A M Kerstjens, estimating decline in smokers.Because of its carefully suggesting a later start in non-Department of Pulmonology, ease of measurement and its very good resmokers.It has long been thought that this University Hospital Groningen, producibility, the forced expiratory volume in ensuing decrease is linear -that is, that FEV 1 PO Box 30001, one second (FEV 1 ) is the most widely used and decreases by the same number of ml each year.

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  • Some airways may be narrowed or closed during normal tidal breathing in older individuals, thereby increasing functional residual capacity and reducing expiratory airflow from the lungs.

    “As a result, some airways may be narrowed or closed during normal tidal breathing in older individuals, thereby increasing the functional residual capacity and reducing the expiratory airflow from the lungs (12, 13).”

    From Aging and Lung Disease (2020) · cites this paper as [13]

  • There is an age-associated decline in the FEV1/FVC ratio.

    “Specifically, there is a decline in forced expiratory volume (FEV1) by approximately 30 mL/year and forced vital capacity (FVC) by approximately 20 mL/year, which results in an age-associated decline in the FEV1/FVC ratio (7, 12–14, 20, 21).”

    From Aging and Lung Disease (2020) · cites this paper as [13]

  • Even in healthy persons, lung function declines starting at the age of 35.

    “It is well appreciated that, even in healthy persons, lung function declines starting at the age of 35.”

    From Aging and Lung Disease (2020) · cites this paper as [13]

  • There is a decline in forced vital capacity (FVC) by approximately 20 mL/year with age.

    “Specifically, there is a decline in forced expiratory volume (FEV1) by approximately 30 mL/year and forced vital capacity (FVC) by approximately 20 mL/year, which results in an age-associated decline in the FEV1/FVC ratio (7, 12–14, 20, 21).”

    From Aging and Lung Disease (2020) · cites this paper as [13]

  • There is a decline in forced expiratory volume in one second (FEV1) by approximately 30 mL/year with age.

    “Specifically, there is a decline in forced expiratory volume (FEV1) by approximately 30 mL/year and forced vital capacity (FVC) by approximately 20 mL/year, which results in an age-associated decline in the FEV1/FVC ratio (7, 12–14, 20, 21).”

    From Aging and Lung Disease (2020) · cites this paper as [13]

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Cites

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Research works printed but not linked: 9

  1. Buist AS. Evaluation of lung function: concepts of normality. It has long been shown that smoking -both In: Simmons DH, ed. Current pulmonology. New York: active and passive -has a negative influence John Wiley & Sons, 1982: 141-65.
  2. the peak achieved during early adulthood, the 25 American Thoracic Society. Lung function testing: selection of reference values and interpretative strategies. Am Rev duration of the ensuing early adulthood plateau Respir Dis 1991;144:1202-18.
  3. American Thoracic Society. Standardization of spirometry, function than non-smokers. 1994 update. Am J Respir Crit Care Med 1995;152:1107- Finally, most reference values currently in 36.
  4. Tager IB, Munoz A, Rosner B, Weiss S, Carey V. Effect of ings in healthy nonsmokers. Am Rev Respir Dis 1986;133: 974-80. cigarette smoking on the pulmonary function of children and adolescents. Am Rev Respir Dis 1985;131:752-9.
  5. Dockery DW, Ware JH, Ferris BG Jr, Glicksberg DS, Fay 1987;136:69-75.
  6. Burrows B, Bloom JW, Traver GA, Cline MG. The course Bull Eur Physiopathol Respir 1981;17:775-92. and prognosis of different forms of chronic airways ob- 42
  7. Tashkin DP, Altose MD, Connett JE, Kanner RE, Lee WW, Thoracic Society. Thorax 1990;45:835-40.
  8. Tashkin DP, Clark VA, Coulson AH, Simmons M, Bourque Crit Care Med 1996;154:S246-9.
  9. Anthonisen NR, Connett JE, Kiley JP, Altose MD, Bailey 73 Hendrick DJ. Occupation and chronic obstructive pul- WC, Buist AS, et al. Effects of smoking intervention and monary disease (review). Thorax 1996;51:947-55. the use of an inhaled anticholinergic bronchodilator on 74 Christiani DC. Organic dust exposure and chronic airways the rate of decline of FEV 1 : the Lung Health Study. JAMA disease (editorial). Am J Respir Crit Care Med 1996;154: 1994;272:1497-505. 833-4.

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Authors
Kerstjens, H. A., Rijcken, B., Schouten, J. P., & Postma, D. S.
Affiliations
University of Groningen (NL)
ORCID
Venue
Thorax
Publisher
BMJ
Published
1997-09-01
Volume
52
Issue
9
Pages
820-827
ISSN
0040-6376 (ISSN-L)
DOI
10.1136/thx.52.9.820
PMC
PMC1758654
OpenAlex
W2164603088
Cited by
284
References
60
Citations by year
2026: 1 · 2025: 5 · 2024: 8 · 2023: 9 · 2022: 7 · 2021: 12 · 2020: 17 · 2019: 12 · 2018: 16 · 2017: 13 · 2016: 17 · 2015: 17 · 2014: 9 · 2013: 14 · 2012: 14
FWCI
5.16
Type
journal article
Language
en
Open access
Locations
  • Thorax (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
Keywords
FEV1 decline, lung function reference values, age-related lung function decline, smoking, pulmonary function tests, healthy adults
MeSH terms
Adult, Aged, Aged, 80 and over, Aging, Cross-Sectional Studies, Female, Forced Expiratory Volume, Humans, Lung, Lung Diseases, Obstructive, Male, Middle Aged, Reference Values, Smoking, Vital Capacity

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