General population-based lung function trajectories over the life course: an accelerated cohort study
Understanding life course lung function trajectories: background and aim
Lung function is a key determinant of health, but current knowledge on lung function growth and decline over the life course is based on fragmented, potentially biased data.
We aimed to empirically derive general population-based life course lung function trajectories, and to identify breakpoints and plateaus.
How life course lung function trajectories were studied: methods from eight cohorts
We created an accelerated cohort by pooling data from eight general population-based child and adult cohort studies from Europe and Australia.
We included all participants with information on lung function, smoking status, BMI, and asthma diagnosis status from at least two visits.
We used cross-classified three-level linear mixed models to derive sex-specific life course trajectories of FEV1, forced vital capacity (FVC), and FEV1/FVC ratio based on observations at ages 4–80 years, and Bayesian time-series decomposition to identify breakpoints and plateaus.
We repeated sex-specific analyses with separate stratification for asthma status (never had asthma vs persistent asthma, where persistent was defined as the risk factor being present at all participant visits) and smoking status (never smoker vs persistent smoker).
What life course lung function trajectories reveal: key interpretation
In both sexes, FEV1 and FVC increased in two phases, with a fast increase until around age 13–16 years, and then a slower increase until a peak.
Neither parameter showed a plateau phase after the peak, and decreases started earlier than previously described. FEV1/FVC ratio decreased throughout life.
These observations provide an essential, but previously unavailable, framework to assess and monitor lung health over the life course.
Authors
Prof Judith Garcia-Aymerich PhD, Martí de las Heras BStats, Anne-Elie Carsin MSc, Prof Simone Accordini MSc, Prof Alvar Agustí MD, Dinh Bui PhD, Prof Shyamali C Dharmage PhD, Prof James W Dodd PhD, Ikenna Eze PhD, Ulrike Gehring PhD, Prof Thorarinn Gislason MD, Raquel Granell PhD, Medea Imboden PhD, Carmen Íñiguez PhD, Ayoung Jeong PhD, Sarah Koch PhD, Prof Gerard H Koppelman PhD, Bénédicte Leynaert PhD, Prof Erik Melén MD, Jennifer Perret PhD, Prof Nicole Probst-Hensch PhD, Loreto Santa-Marina PhD, Maties Torrent PhD, Don Vicendese PhD, Judith M Vonk PhD, Maaike de Vries PhD, Prof E Haydn Walters DM, Gang Wang MD, Prof Jadwiga A Wedzicha MD, Prof Deborah Jarvis MD, Rosa Faner PhD
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Fecha de publicación
Available online 15 May 2025
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