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呼吸困难维度与身体和精神健康相关:基于人群的老年男性 VASCOL 研究。

Breathlessness dimensions association with physical and mental quality of life: the population based VASCOL study of elderly men.

机构信息

Faculty of Medicine, Department of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund University, Lund, Sweden.

Faculty of Heath, University of Technology Sydney, Sydney, New South Wales, Australia.

出版信息

BMJ Open Respir Res. 2021 Nov;8(1). doi: 10.1136/bmjresp-2021-000990.

Abstract

BACKGROUND

Breathlessness is a multidimensional symptom prevalent in elderly affecting many aspects of life. We aimed to determine how different dimensions of breathlessness are associated with physical and mental quality of life (QoL) in elderly men.

METHODS

This was a cross-sectional, population-based analysis of 672 men aged 73 years in a Swedish county. Breathlessness was assessed using Dyspnoea-12 (D-12) and Multidimensional Dyspnoea Profile (MDP), and QoL using the Short Form 12 physical and mental scores. Scores were compared as z-scores across scales and analysed using multivariable linear regression, adjusted for smoking, body mass index and the presence of respiratory and cardiovascular disease.

RESULTS

Worse breathlessness was related to worse physical and mental QoL across all the D-12 and MDP dimension scores. Physical QoL was most strongly associated with perceptional breathlessness scores, D-12 total and physical scores (95% CI -0.45 to -0.30). Mental QoL was more strongly influenced by affective responses, MDP emotional response score (95% CI -0.61 to -0.48). Head-to-head comparison of the instruments confirmed that D-12 total and physical scores most influenced physical QoL, while mental QoL was mostly influenced by the emotional responses captured by the MDP.

CONCLUSION

Breathlessness dimensions and QoL measures are associated differently. Physical QoL was most closely associated with sensory and perceptual breathlessness dimensions, while emotional responses were most strongly associated with mental QoL in elderly men. D-12 and MDP contribute complimentary information, where affective and emotional responses may be related to function, deconditioning and QoL.

摘要

背景

呼吸困难是一种普遍存在于老年人中的多维症状,影响着生活的许多方面。我们旨在确定呼吸困难的不同维度与老年男性的身体和心理健康生活质量(QoL)之间的关系。

方法

这是一项基于人群的横断面研究,分析了瑞典一个县 672 名 73 岁男性。使用呼吸困难-12 (D-12)和多维呼吸困难量表(MDP)评估呼吸困难,使用 12 项简短健康调查量表的身体和心理评分评估 QoL。在各个量表上比较评分的 z 分数,并使用多变量线性回归进行分析,调整了吸烟、体重指数以及呼吸系统和心血管疾病的存在。

结果

呼吸困难越严重,与所有 D-12 和 MDP 维度评分的身体和心理健康 QoL 越差相关。身体 QoL 与感知呼吸困难评分、D-12 总分和身体评分的相关性最强(95%CI -0.45 至 -0.30)。心理 QoL 受情感反应的影响更大,MDP 情绪反应评分(95%CI -0.61 至 -0.48)。两种工具的直接比较证实,D-12 总分和身体评分对身体 QoL 的影响最大,而心理 QoL 主要受 MDP 所捕捉的情感反应影响。

结论

呼吸困难维度和 QoL 测量的关联不同。身体 QoL 与感觉和感知呼吸困难维度最密切相关,而情绪反应与老年男性的心理 QoL 最密切相关。D-12 和 MDP 提供了互补的信息,其中情感和情绪反应可能与功能、去适应和 QoL 有关。

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