Bendopnea in Geriatric Patients with Different Body Composition Parameters: An Observational Study

Bendopnea, a recently described new symptom of dyspnea that occurs during trunk flexion, and the bending oxygen saturation index (BOSI) are of interest for further research and application in geriatric practice.

OBJECTIVE: The aim of this study was to investigate the incidence of bendopnea in geriatric patients with varying body composition, including obesity, sarcopenia, and sarcopenic obesity.

MATERIALS AND METHODS. The bendopnea symptoms and the BOSI were studied in  a cross-sectional, observational study involving 100 individuals of advanced age with sarcopenia or sarcopenic obesity as well as control groups with obesity or no sarcopenia/sarcopenic obesity. Bendopnea was defined as dyspnea occurring after 30 seconds of transverse trunk flexion in a seated position of patient. Simultaneously, the BOSI was calculated by subtracting the oxygen saturation values before and after the bendopnea test, using pulse oximetry.

RESULTS. The average age of the participants was 76.16 ± 7.71 years, with women accounting for the majority (72%). The group with sarcopenic obesity showed the highest number of  positive bendopnea symptoms (65.38%), with statistically significant differences compared to the group with sarcopenia (26.92%) (p = 0.01); the group with obesity without sarcopenia (30.77%) (p = 0.01) and the control group (22.73%) (p < 0.001), respectively. The bendopnea was most commonly reported in patients actively experiencing dyspnea, with higher scores on the Borg dyspnea scale and severity on the Modified Medical Research Council (mMRC) scale. These patients also had lower grip strength, higher waist circumferences, and body mass index. No statistically significant differences were found when comparing the BOSI indices of patients with and without positive bendopnea.

CONCLUSION. Bendopnea may be a promising additional diagnostic tool for dyspnea in older patients. Given its high incidence in sarcopenic obesity, further studies are required to assess its prognostic value in this category of older patients.

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