Author:

Keywords:

Science & Technology, Life Sciences & Biomedicine, Geriatrics & Gerontology, Older people, dyspnoea, adults aged 80 and over, correlates, adverse outcomes, RESPIRATORY SYMPTOMS, OLDER-PEOPLE, PREVALENCE, PREDICTOR, COMMUNITY, MORTALITY, SOCIETY, DISEASE, Age Factors, Aged, 80 and over, Aging, Belgium, Biomarkers, Body Mass Index, Cardiovascular Diseases, Disability Evaluation, Disease Progression, Dyspnea, Female, Forced Expiratory Volume, Geriatric Assessment, Hospitalization, Humans, Kaplan-Meier Estimate, Logistic Models, Lung, Male, Multivariate Analysis, Natriuretic Peptide, Brain, Odds Ratio, Peptide Fragments, Prevalence, Prognosis, Proportional Hazards Models, Prospective Studies, Risk Factors, Time Factors, 1103 Clinical Sciences, 1117 Public Health and Health Services, 1701 Psychology, Geriatrics, 3202 Clinical sciences, 4203 Health services and systems, 5201 Applied and developmental psychology

Abstract:

BACKGROUND: adults aged 80 and over, a fast growing age-group, with increased co-morbidity and frailty have not been the focus of previous research on dyspnoea. We investigate the correlates of dyspnoea and its association with adverse outcomes in a cohort of adults aged 80 and over. METHODS: about 565 community-dwelling adults aged 80 and over of the BELFRAIL prospective cohort had assessment of Medical Research Council dyspnoea scale (MRC), forced expiratory volume in 1 s (FEV1), N-terminal pro-brain natriuretic peptide (NT-proBNP), physical performance tests, grip strength, 15 items geriatric depression scale, activities of daily living (ADL), body mass index (BMI) and demographics data. Kaplan-Meier survival curves, Cox and logistic multivariable regression, classification and regression tree (CART) analysis assessed association of dyspnoea (MRC 3-5) with time-to-cardiovascular and all-cause death (5 years), time to first hospitalisation (3 years), new/worsened ADL disability (2 years), and its correlates. RESULTS: participants with dyspnoea MRC 3-5 (29.9%) had increased hazard ratios for cardiovascular mortality 2.85 (95% confidence interval 1.93-4.20), all-cause mortality 2.04 (1.58-2.64), first hospitalisation 1.72 (1.35-2.19); and increased odds ratio for new/worsened disability 2.49 (1.54-4.04), independent of age, sex and smoking status. Only FEV1, physical performance, BMI and NT-proBNP (in order of importance) were selected in the tree-based classification model for dyspnoea. CONCLUSIONS: in a cohort of adults aged 80 and over, dyspnoea was common and an independent predictor of adverse outcomes, with cardio-respiratory and physical performance impairments as key independent correlates. Its routine and comprehensive evaluation in primary care could be very valuable in caring for this age-group.