title: Dyspnoea and mortality in older people in the community: a 10-year follow-up.
abstract: BACKGROUND
  examine baseline dyspnoea and subsequent 10-year mortality adjusting for age and gender and determine whether dyspnoea is related to early or late mortality or both. Examine the relationship between dyspnoea and mortality adjusting for confounding effects of underlying diseases.
  
  
  METHODS
  we sent modified Medical Research Council (MRC) dyspnoea questionnaire to identify breathlessness in 1,404 randomly selected subjects from general practitioner lists of 5,002 subjects aged 70 years and over living in the community. A further random sample of 500 subjects underwent clinical assessment including pulmonary function tests, electrocardiography and echocardiography. Subjects were followed up for 10 years and all deaths were recorded, using general practitioner records and the local death registry.
  
  
  RESULTS
  prevalence of dyspnoea was 32.3%. Breathlessness was associated with early mortality and late mortality. At 2 years 10.1% breathless subjects died compared with 3.4% non-breathless (P=0.02). At 10 years 63.3% breathless had died compared with 40.5% non-breathless (P=0.0001). Increasing grade of MRC dyspnoea was associated with 10 mortality. Advancing age (OR: 2.27), male gender (OR: 1.95), breathlessness (OR: 2.53), left ventricular dysfunction (OR: 5.01) and chronic airways disease (OR: 3.04) were all significantly associated with 10-year mortality. After adjustment of age, gender and underlying diseases breathlessness was associated with 10-year mortality (P=0.02).
  
  
  CONCLUSIONS
  dyspnoea is a predictor of early and late mortality and increasing grade of dyspnoea is associated with a higher rate of mortality. Dyspnoea is an independent risk factor for mortality after adjustment for age, gender and underlying diseases.
authors.affiliation: Geriatric Department, University Hospital of Llandough, Cardiff, UK. ahmedte1000@hotmail.com
authors.forename: Tanvir
authors.initials: T
authors.lastname: Ahmed
authors.forename: John A
authors.initials: JA
authors.lastname: Steward
authors.forename: M Sinead
authors.initials: MS
authors.lastname: O'Mahony
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D004417:Dyspnea / Q000175:diagnosis / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D058006:General Practice; D006334:Heart Function Tests; D006801:Humans; D057187:Independent Living; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D015995:Prevalence; D016016:Proportional Hazards Models; D012042:Registries; D012129:Respiratory Function Tests; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D014852:Wales / Q000453:epidemiology