Effects of Obesity in the Aged

肥胖对老年人的影响

• 批准号: 10468906
• 负责人: TONY G BABB
• 金额: $ 50.45万
• 依托单位: UT SOUTHWESTERN MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-15 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10468906
• 关键词: Abdomen; Activities of Daily Living; Adult; Affective; Aging; Body Weight decreased; Breathing; Cardiopulmonary; Caring; Chest; Chest wall structure; Clinical; Coupled; Diagnosis; Dimensions; Dyspnea; Elderly; Ergometry; Exercise; Exercise Tolerance; Exertion; Fatty acid glycerol esters; Functional Residual Capacity; Laboratories; Lead; Lung; Mechanics; Medical Research Council Dyspnea Scale; Metabolic; Non obese; Obesity; Overweight; Perception; Physical Fitness; Prevention; Pulmonary Heart Disease; Respiration; Respiratory Mechanics; Respiratory Signs and Symptoms; Respiratory physiology; Rest; Risk; Sensory; Shortness of Breath; Supination; Testing; Time; Woman; Work; Work of Breathing; adult obesity; age related; aged; base; cost; deconditioning; exercise intolerance; experience; improved; lung volume; mechanical load; men; novel; obesity treatment; overweight adults; preservation; pressure; pulmonary function; research clinical testing; respiratory; rib bone structure; treatment strategy; unnecessary treatment; ventilation

PROJECT SUMMARY/ABSTRACT Seventy% of older adults (60+ yr) are overweight or obese and many are unable or unwilling to exercise due to exercise intolerance and/or dyspnea on exertion (DOE). We have identified numerous obesity- related effects that could influence exercise tolerance and DOE in obese adults. We have also identified many age-related ventilatory constraints in nonobese older adults. However, it is unclear whether obesity- related and aging-related effects combine to reduce exercise tolerance, provoke DOE, or contribute to respiratory symptoms in older obese adults. We propose that many of the obesity-related effects in older obese adults are the result of low lung volume breathing, i.e., a reduction in functional residual capacity (FRC) at rest and end-expiratory lung volume (EELV) during exercise. Increased fat on the chest wall produces low FRC and EELV levels, where breathing limitations like expiratory flow limitation (EFL) and enhanced perception of dyspnea are more likely to occur due to the age-related decline in maximal expiratory flow at low lung volumes. Our overall hypothesis is that respiratory limitations, exercise intolerance, DOE, and respiratory symptoms in older obese adults are due to mechanical loading of the thorax and low lung volume breathing. We propose to test this hypothesis with the use an external cuirass (i.e., a plastic shell over the thorax) to mechanically unload the chest wall. This will decrease the load on the thorax thereby increasing FRC at rest and EELV during exercise, and potentially decrease the work of breathing during exercise. The overall objective of this application is to investigate the effects of obesity on lung function, exercise tolerance, and DOE in older obese adults as compared with older adults without obesity, using a novel probe for mechanically unloading the thorax at rest and during exercise. We will use 1) continuous negative cuirass pressure, and 2) assisted biphasic cuirass ventilation to decrease obesity-related effects in older obese adults. Our approach will be to examine respiratory function, exercise tolerance, and DOE with and without mechanical unloading in older obese men and women (65-75 yr), including those with respiratory symptoms, as compared with older adults without obesity. Specific Aims: We will test the following hypotheses: Aim 1) Obesity will decrease respiratory function but to a greater extent in older obese adults with respiratory symptoms; Aim 2) Obesity will decrease exercise tolerance but not cardiorespiratory fitness, except in older obese adults with respiratory symptoms where both may be reduced; Aim 3) Obesity will increase DOE but to a greater extent in older obese adults with respiratory symptoms; and Aim 4) Mechanical unloading of the thorax will improve respiratory function, exercise tolerance, and DOE in older obese adults, but to a greater extent in older obese adults with respiratory symptoms. These results will have broad and immediate clinical impact on the care of older obese adults with DOE.

项目摘要/摘要 70％的老年人（60岁以上）超重或肥胖，许多人无法或不愿运动 由于运动不耐受和/或劳动力障碍（DOE）。我们已经确定了许多肥胖症 - 可能影响肥胖成年人运动耐受性和DOE的相关效果。我们还确定了 非肥胖老年人的许多与年龄相关的通气限制。但是，尚不清楚肥胖症是否 相关和与衰老有关的效果结合在一起，以降低运动耐受性，挑衅或有助于 老年肥胖成年人的呼吸道症状。我们提出，老年人的许多与肥胖相关的作用 肥胖的成年人是肺部呼吸低的结果，即功能残留能力降低 （FRC）运动过程中休息和肺肺肺量（EELV）。胸壁上的脂肪增加 产生低FRC和EELV水平，其中呼吸限制（例如呼气流量限制（EFL））和 由于年龄相关的最大下降，对呼吸困难的感知增强更可能发生 低肺体积处的呼气流。我们的总体假设是呼吸局限性，锻炼 老年肥胖成年人的不耐受性，DOE和呼吸道症状是由于机械加载 胸腔和低肺体积呼吸。我们建议使用外部甲壳来检验这一假设 （即，胸部上方的塑料外壳）机械地卸下胸壁。这将减少负载 胸部在锻炼过程中静止和EELV时增加了FRC，并有可能减少 运动过程中的呼吸。该应用的总体目的是研究 与年龄较大的老年人相比 没有肥胖的成年人，使用新颖的探针在休息和期间机械地卸下胸部 锻炼。我们将使用1）连续的负墨丽压力，而2）辅助双相墨水 通风以减少老年肥胖成年人的肥胖相关作用。我们的方法是检查 呼吸功能，运动耐受性和DOE，有和没有机械卸载的老年肥胖 与老年人相比 没有肥胖。具体目的：我们将测试以下假设：目标1）肥胖症会减少 呼吸功能，但在年龄较大的肥胖成年人中，患有呼吸道症状；目标2） 肥胖症会降低运动耐受性，但不能降低心肺健康 患有呼吸道症状的成年人可能会减少两者；目的3）肥胖会增加努力，但 在年龄较大的肥胖成年人中，患有呼吸道症状；目标4）机械 胸腔的卸载将改善呼吸功能，运动耐受性和较老的DOE 肥胖的成年人，但在呼吸道症状的老年肥胖成年人中更大程度上。这些结果 将对有能源的老年肥胖成年人的护理产生广泛而直接的临床影响。