Health Sciences North Research Institute, Sudbury, Ontario, Canada.
Northern Ontario School of Medicine, Sudbury, Ontario, Canada.
J Gen Intern Med. 2022 Oct;37(13):3302-3309. doi: 10.1007/s11606-021-07374-4. Epub 2022 Jul 11.
Dyspnea is associated with functional impairment and impaired quality of life. There is limited information on the potential risk factors for dyspnea in an older adult population.
Among older adults aged 45 to 85 years of age, what sociodemographic, environmental, and disease related factors are correlated with dyspnea?
We used cross-sectional questionnaire data collected on 28,854 participants of the Canadian Longitudinal Study of Aging (CLSA). Multinomial regression was used to assess the independent effect of individual variables adjusting for the other variables of interest.
The adjusted odds ratios for dyspnea "walking on flat surfaces" were highest for obesity (OR, 5.71; 95%CI, 4.71-6.93), lung disease (OR, 3.91; 95%CI, 3.41-4.49), and depression (OR, 3.68; 95%CI, 3.15-4.29), and were greater than 2 for lower income, and heart disease. The effect of diabetes remained significant after adjusting for sociodemographics, heart disease and BMI (OR, 1.61; 95%CI, 1.39-1.86). Those with both respiratory disease and depression had a 12.78-fold (95%CI, 10.09-16.19) increased odds of exertional dyspnea, while the corresponding OR for the combination of heart disease and depression was 18.31 (95%CI, 13.4-25.01).
In a community sample of older adults, many correlates of dyspnea exist which have significant independent and combined effects. These factors should be considered in the clinical context where dyspnea is out of proportion to the degree of heart and lung disease. Whether or not diabetes may possibly be a risk factor for dyspnea merits further investigation.
呼吸困难与功能障碍和生活质量受损有关。关于 45 至 85 岁的老年人中,哪些社会人口统计学、环境和疾病相关因素与呼吸困难有关,相关信息有限。
在年龄为 45 至 85 岁的老年人中,哪些社会人口统计学、环境和疾病相关因素与呼吸困难有关?
我们使用了加拿大老龄化纵向研究(CLSA)中 28854 名参与者的横断面问卷调查数据。使用多项回归来评估个体变量的独立影响,同时调整其他感兴趣的变量。
对于“在平坦表面行走”的呼吸困难,肥胖(OR,5.71;95%CI,4.71-6.93)、肺部疾病(OR,3.91;95%CI,3.41-4.49)和抑郁症(OR,3.68;95%CI,3.15-4.29)的调整比值比最高,而收入较低和心脏病的比值比大于 2。在调整社会人口统计学、心脏病和 BMI 后,糖尿病的影响仍然显著(OR,1.61;95%CI,1.39-1.86)。同时患有肺部疾病和抑郁症的人,出现劳力性呼吸困难的几率增加了 12.78 倍(95%CI,10.09-16.19),而心脏病和抑郁症同时存在的人,出现呼吸困难的几率增加了 18.31 倍(95%CI,13.4-25.01)。
在一个社区样本的老年人中,许多呼吸困难的相关因素存在显著的独立和综合影响。在呼吸困难与心肺疾病的严重程度不成比例的情况下,应在临床环境中考虑这些因素。糖尿病是否可能是呼吸困难的一个危险因素,值得进一步研究。