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Family Practice Advance Access published online on August 22, 2005
Family Practice, doi:10.1093/fampra/cmi064
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© The Author (2005). Published by Oxford University Press. All rights reserved.
Received March 25, 2005
Accepted June 20, 2005

Article

Dyspnea in elderly family practice patients. Occurrence, severity, quality of life and mortality over an 8-year period

Bèr Huijnen 1, Frans van der Horst 1*, Ludovic van Amelsvoort 2, Geertjan Wesseling 3, Marieke Lansbergen 4, Pepijn Aarts 5, Nancy Nicolson 6, and André Knottnerus 1

1 Department of General Practice, Maastricht University
2 Department of Epidemiology, Maastricht University
3 Department of Pulmonology, Academic Hospital Maastricht/Maastricht University
4 MEMIC; Centre for Data and Information Management, Maastricht University
5 Assistant in General Practice, Maastricht University
6 Department of Psychiatry and Neuropsychology, Maastricht University

* To whom correspondence should be addressed.
Frans van der Horst, E-mail: frans.vanderhorst{at}hag.unimaas.nl


  Abstract

Background and objectives. 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.

Keywords: Dyspnea; health; daily functioning; quality of life; mortality.
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