Peak Expiratory Flow as an Index of Frailty Syndrome in Older Adults: A Cross-Sectional Study



to compare the obtained and predicted peak expiratory flow (PEF) values between frail, pre-frail, and non-frail older adults; verify the association between PEF and FS; and establish cut-off points for PEF as determinants of frailty syndrome (FS).


Cross-sectional study.


Macapa, Amapa, Brazil.


Community-based study community-dwelling older people.


PEF was evaluated using a peak-flow meter and FS was evaluated using Fried’s frailty phenotype. The statistical analyses performed included a multinomial logistic regression model and Receiver Operating Characteristic (ROC) curves to establish cut-off points for discriminating FS.


409 older adults with a mean age of 70.09±7.22 years were evaluated; of these, 58.7% were pre-frail, and 12.7% were frail. PEF was lower in frail than in pre-frail participants, and lower in pre-frail than in non-frail. Frail and pre-frail older adults obtained lower PEF values than predicted. PEF (% Predicted) was inversely associated with frailty and pre-frailty even after adjustment. Cut-off points were established to discriminate the presence of frailty in older men (PEF≤350L/min; AUC=0.669; sensitivity=76.92%; specificity=52%) and women (PEF≤220L/min; AUC=0.597; sensitivity=71.79%; specificity=46.98%).


Frail and pre-frail older adults presented significantly lower PEF than non-frail participants, and these values were lower than predicted. PEF was inversely associated with frailty and pre-frailty. PEF cut-off points can be used as a complementary method to indicate frailty in community-dwelling older adults.

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This research was financed by the Foundation for Research Support of the State of Amapa (FAPEAP, Concession no 250.203.029/2016).

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Corresponding author

Correspondence to Maycon Sousa Pegorari.

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Ethicals declaration

This study received approval from the Research Ethics Committee of the Federal University of Amapa, number 1.738.671.

Conflict of interest disclosure

There was no conflict of interest.

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Magave, J.A., Bezerra, S.J.S., Matos, A.P. et al. Peak Expiratory Flow as an Index of Frailty Syndrome in Older Adults: A Cross-Sectional Study. J Nutr Health Aging (2020).

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Key words

  • Aging
  • frail elderly
  • respiratory function tests
  • peak expiratory flow rate
  • respiratory muscles