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Correlates of dyspnoea and its association with adverse outcomes in a cohort of adults aged 80 and over.
- Source :
-
Age and ageing [Age Ageing] 2017 Nov 01; Vol. 46 (6), pp. 994-1000. - Publication Year :
- 2017
-
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.<br />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.<br />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.<br />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.<br /> (© The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com)
- Subjects :
- Age Factors
Aged, 80 and over
Aging
Belgium epidemiology
Biomarkers blood
Body Mass Index
Cardiovascular Diseases diagnostic imaging
Cardiovascular Diseases mortality
Cardiovascular Diseases therapy
Disability Evaluation
Disease Progression
Dyspnea diagnosis
Dyspnea mortality
Dyspnea therapy
Female
Forced Expiratory Volume
Geriatric Assessment
Hospitalization
Humans
Kaplan-Meier Estimate
Logistic Models
Male
Multivariate Analysis
Natriuretic Peptide, Brain blood
Odds Ratio
Peptide Fragments blood
Prevalence
Prognosis
Proportional Hazards Models
Prospective Studies
Risk Factors
Time Factors
Cardiovascular Diseases physiopathology
Dyspnea physiopathology
Lung physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1468-2834
- Volume :
- 46
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Age and ageing
- Publication Type :
- Academic Journal
- Accession number :
- 28633384
- Full Text :
- https://doi.org/10.1093/ageing/afx095