Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK.
Hull Health Trials Unit, Hull York Medical School, University of Hull, Hull, UK.
Age Ageing. 2023 Sep 1;52(9). doi: 10.1093/ageing/afad155.
Long-term breathlessness is more common with age. However, in the oldest old (>85 years), little is known about the prevalence, or impact of breathlessness. We estimated breathlessness limiting exertion prevalence and explored (i) associated characteristics; and (ii) whether breathlessness limiting exertion explains clinical and social/functional outcomes.
Health and socio-demographic characteristics were extracted from the Newcastle 85+ Study cohort. Phase 1 (baseline) and follow-up data (18 months, Phase 2; 36 months, Phase 3; 60 months, Phase 4 after baseline) were examined using descriptive statistics and cross-sectional regression models.
Eight hundred seventeen participants provided baseline breathlessness data (38.2% men; mean 84.5 years; SD 0.4). The proportions with any limitation of exertion, or severe limitation by breathlessness were 23% (95% confidence intervals (CIs) 20-25%) and 9% (95%CIs 7-11%) at baseline; 20% (16-25%) and 5% (3-8%) at Phase 4. Having more co-morbidities (odds ratio (OR) 1.34, 1.18-1.54; P < 0.001), or self-reported respiratory (OR 1.88, 1.25-2.82; P = 0.003) or cardiovascular disease (OR 2.38, 1.58-3.58; P < 0.001) were associated with breathlessness limiting exertion. Breathlessness severely limiting exertion was associated with poorer self-rated health (OR 0.50, 029-0.86; P = 0.012), depression (beta-coefficient 0.11, P = 0.001), increased primary care contacts (beta-co-efficient 0.13, P = 0.001) and number of nights in hospital (OR 1.81; 1.02-3.20; P = 0.042).
Breathlessness limiting exertion appears to become less prevalent over time due to death or withdrawal of participants with cardio-respiratory illness. Breathlessness severely limiting exertion had a wide range of service utilisation and wellbeing impacts.
随着年龄的增长，长期呼吸困难更为常见。然而，在最年长的老年人（>85 岁）中，对于呼吸困难的患病率或影响知之甚少。我们估计了限制用力呼吸的呼吸困难患病率，并探讨了（i）相关特征；以及（ii）呼吸困难是否会限制用力呼吸对临床和社会/功能结果的影响。
从纽卡斯尔 85+研究队列中提取健康和社会人口统计学特征。使用描述性统计和横截面回归模型检查第 1 阶段（基线）和随访数据（第 2 阶段 18 个月；第 3 阶段 36 个月；第 4 阶段 60 个月，基线后）。
817 名参与者提供了基线呼吸困难数据（38.2%为男性；平均 84.5 岁；标准差 0.4）。基线时，任何用力受限或严重呼吸困难受限的比例分别为 23%（95%置信区间[CI]为 20-25%）和 9%（95%CI 为 7-11%）；第 4 阶段分别为 20%（16-25%）和 5%（3-8%）。患有更多合并症（比值比[OR]为 1.34，1.18-1.54；P<0.001），或自我报告的呼吸系统疾病（OR 为 1.88，1.25-2.82；P=0.003）或心血管疾病（OR 为 2.38，1.58-3.58；P<0.001）与呼吸困难限制用力呼吸有关。严重限制用力呼吸的呼吸困难与较差的自我报告健康状况（OR 为 0.50，0.29-0.86；P=0.012）、抑郁（β系数为 0.11，P=0.001）、初级保健接触增加（β系数为 0.13，P=0.001）和住院夜数（OR 为 1.81；1.02-3.20；P=0.042）有关。
由于心肺疾病患者死亡或退出，限制用力呼吸的呼吸困难似乎随着时间的推移而变得不那么普遍。严重限制用力呼吸的呼吸困难有广泛的服务利用和健康影响。
