Dyspnea in elderly family practice patients. Occurrence, severity, quality of life and mortality over an 8-year period

Background and objectives. This study examined the prevalence and severity of dyspnea in patients ≥70 years of age and its impact on the quality of life. We also examined the prognostic significance of dyspnea for mortality. Methods. The cohort study started with a mailed questionnaire, supplemented...

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Bibliographic Details
Published in:Family practice 2006-02, Vol.23 (1), p.34-39
Main Authors: Huijnen, Bèr, van der Horst, Frans, van Amelsvoort, Ludovic, Wesseling, Geertjan, Lansbergen, Marieke, Aarts, Pepijn, Nicolson, Nancy, Knottnerus, André
Format: Article
Language:English
Subjects:
Activities of daily living
Age Factors
Aged
Aged, 80 and over
Cause of Death
Cohort Studies
daily functioning
Dyspnea
Dyspnea - diagnosis
Dyspnea - mortality
Dyspnea - therapy
Dyspnoea
Elderly people
Family Practice
Female
Geriatric Assessment
health
Humans
Lung diseases
Male
Mortality
Netherlands - epidemiology
Prevalence
Proportional Hazards Models
Quality of Life
Respiratory Function Tests
Severity of Illness Index
Sex Factors
Survival Analysis
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Summary:Background and objectives. This study examined the prevalence and severity of dyspnea in patients ≥70 years of age and its impact on the quality of life. We also examined the prognostic significance of dyspnea for mortality. Methods. The cohort study started with a mailed questionnaire, supplemented with an interview. From the population of elderly patients in a family practice health center, a one in five sample (n = 124) was randomly selected, similar in age and sex distribution to those not in the sample. Demographic and other relevant variables were examined for their association with dyspnea. Cox proportional hazards ratio analysis was done with dyspnea (MRC, BDI scores) as independent and mortality as dependent variable. Results. Baseline data indicated that 23% (MRC) to 37% (BDI) of the patients had moderate to severe dyspnea. Shortness of breath was associated with older age, poor perceived health, more anxiety and depressive symptoms, impaired daily functioning, and lower happiness. Moderate and severe dyspnea measured with BDI and MRC was a significant predictor of death within eight years due to cardiovascular or lung disease. Selective participation did not appear to have biased this outcome. Conclusions. Dyspnea occurs frequently in the elderly, is associated with poor health, and interferes with daily functioning. Results suggest that dyspnea contributes to mortality. Development and implementation of guidelines would be highly desirable. Early diagnosis is valuable because this provides opportunities to positively influence the patient's functional condition.
ISSN:0263-2136
1460-2229
DOI:10.1093/fampra/cmi064