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Participants answered interviewer-administered respiratory questionnaires and performed pre-\/post-bronchodilator spirometric tests at 18-month intervals; computed tomography (CT) imaging was performed at baseline. Statistical analyses to describe the relationship between eosinophil levels and decline in forced expiratory volume in 1\u2005s (FEV<jats:sub>1<\/jats:sub>) were performed using random mixed-effects regression models with adjustments for demographics, smoking, baseline FEV<jats:sub>1<\/jats:sub>, ever-asthma and history of exacerbations in the previous 12\u2005months. CT measurements were compared between eosinophil subgroups using ANOVA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Participants who had a peripheral eosinophil count of \u2265300\u2005cells\u00b7\u00b5L<jats:sup>\u22121<\/jats:sup>(n=273) had a greater decline in FEV<jats:sub>1<\/jats:sub>compared with those with eosinophil counts of &lt;150\u2005cells\u00b7\u00b5L<jats:sup>\u22121<\/jats:sup>(n=430; p=0.003) (reference group) and 150\u2013&lt;300\u2005cells\u00b7\u00b5L<jats:sup>\u22121<\/jats:sup>(n=417; p=0.003). The absolute change in FEV<jats:sub>1<\/jats:sub>was \u221232.99\u2005mL\u00b7year<jats:sup>\u22121<\/jats:sup>for participants with eosinophil counts &lt;150\u2005cells\u00b7\u00b5L<jats:sup>\u22121<\/jats:sup>; \u221238.78\u2005mL\u00b7year<jats:sup>\u22121<\/jats:sup>for those with 150\u2013&lt;300\u2005cells\u00b7\u00b5L<jats:sup>\u22121<\/jats:sup>and \u221267.30\u2005mL\u00b7year<jats:sup>\u22121<\/jats:sup>for participants with \u2265300\u2005cells\u00b7\u00b5L<jats:sup>\u22121<\/jats:sup>. In COPD, higher eosinophil count was associated with quantitative CT measurements reflecting both small and large airway abnormalities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A blood eosinophil count of \u2265300\u2005cells\u00b7\u00b5L<jats:sup>\u22121<\/jats:sup>is an independent risk factor for accelerated lung function decline in older adults and is related to undetected structural airway abnormalities.<\/jats:p><\/jats:sec>","DOI":"10.1183\/13993003.00838-2020","type":"journal-article","created":{"date-parts":[[2021,1,20]],"date-time":"2021-01-20T19:17:32Z","timestamp":1611170252000},"page":"2000838","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":86,"title":["High eosinophil counts predict decline in FEV<sub>1<\/sub>: results from the CanCOLD study"],"prefix":"10.1183","volume":"57","author":[{"given":"Wan C.","family":"Tan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7649-038X","authenticated-orcid":false,"given":"Jean","family":"Bourbeau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilbert","family":"Nadeau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Barnes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah H.","family":"Landis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miranda","family":"Kirby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James C.","family":"Hogg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Don D.","family":"Sin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2020,12,10]]},"reference":[{"key":"2024102102074677000_57.5.2000838.1","first-page":"974","article-title":"Longitudinal changes in forced expiratory volume in one second in adults. 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