title: Dyspnea in elderly family practice patients. Occurrence, severity, quality of life and mortality over an 8-year period.
abstract: OBJECTIVE
  This study examined the prevalence and severity of dyspnea in patients >/=70 years of age and its impact on the quality of life. We also examined the prognostic significance of dyspnea for mortality.
  
  
  METHODS
  The cohort study started with a mailed questionnaire, supplemented with an interview. From the population of elderly patients in a family practice health center, a one in five sample (n = 124) was randomly selected, similar in age and sex distribution to those not in the sample. Demographic and other relevant variables were examined for their association with dyspnea. Cox proportional hazards ratio analysis was done with dyspnea (MRC, BDI scores) as independent and mortality as dependent variable.
  
  
  RESULTS
  Baseline data indicated that 23% (MRC) to 37% (BDI) of the patients had moderate to severe dyspnea. Shortness of breath was associated with older age, poor perceived health, more anxiety and depressive symptoms, impaired daily functioning, and lower happiness. Moderate and severe dyspnea measured with BDI and MRC was a significant predictor of death within eight years due to cardiovascular or lung disease. Selective participation did not appear to have biased this outcome.
  
  
  CONCLUSIONS
  Dyspnea occurs frequently in the elderly, is associated with poor health, and interferes with daily functioning. Results suggest that dyspnea contributes to mortality. Development and implementation of guidelines would be highly desirable. Early diagnosis is valuable because this provides opportunities to positively influence the patient's functional condition.
authors.affiliation: Department of Psychiatry and Neuropsychology, Maastricht University, The Netherlands.
authors.forename: Bèr
authors.initials: B
authors.lastname: Huijnen
authors.forename: Frans
authors.initials: F
authors.lastname: van der Horst
authors.forename: Ludovic
authors.initials: L
authors.lastname: van Amelsvoort
authors.forename: Geertjan
authors.initials: G
authors.lastname: Wesseling
authors.forename: Marieke
authors.initials: M
authors.lastname: Lansbergen
authors.forename: Pepijn
authors.initials: P
authors.lastname: Aarts
authors.forename: Nancy
authors.initials: N
authors.lastname: Nicolson
authors.forename: André
authors.initials: A
authors.lastname: Knottnerus
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D015331:Cohort Studies; D004417:Dyspnea / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D005194:Family Practice; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D016016:Proportional Hazards Models; D011788:Quality of Life; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D012737:Sex Factors; D016019:Survival Analysis