Breathlessness in Elderly Adults during the Last Year of Life Sufficient to Restrict Activity: Prevalence, Pattern, and Associated Factors

Miriam Johnson, J Bland, Evelyne Gahbauer, Magnus Ekstrom, Aynharan Sinnarajah, Thomas Gill, David Currow

    Research output: Contribution to conferencePaper

    21 Citations (Scopus)

    Abstract

    Objectives To investigate relationships between age, clinical characteristics, and breathlessness sufficient to have people spend at least half a day a month in bed or to cut down on their usual activities (restricting breathlessness) during the last year of life. Design Secondary data analysis. Setting General community. Participants Nondisabled persons aged 70 and older (N = 754). Measurements Monthly telephone interviews were conducted to determine the occurrence of restricting breathlessness. The primary outcome was percentage of months with restricting breathlessness reported during the last year of life. Results Data regarding breathlessness were available for 548 of 589 (93.0%) participants who died (mean age 86.7, range 71-106; 38.8% male) between enrollment (March 1998 to October 1999) and June 2013; 311 of these (56.8%) reported restricting breathlessness at some point during the last year of life, but none reported it every month. Frequency increased in the months closer to death, irrespective of cause. Restricting breathlessness was associated with anxiety (0.25 percentage points greater in months with breathlessness per percentage point months reported anxiety, 95% confidence interval (CI) = 0.16-0.34, P <.001), depression (0.14, 95% CI = 0.05-0.24, P =.003), and mobility problems (0.07, 0.03-0.1, P <.001). Percentage months of restricting breathlessness was greater if chronic lung disease was noted at the most-recent comprehensive assessment (6.62 percentage points, 95% CI = 4.31-8.94, P <.001), heart failure (3.34 percentage points, 95% CI = 0.71-5.97, P =.01), and ex-smoker status (3.01 percentage points, 95% CI = 0.94-5.07, P =.004) but decreased with older age (-0.19 percentage points, 95% CI = -0.37 to -0.02, P =.03). Conclusion Restricting breathlessness increased in this elderly population in the months preceding death from any cause. Breathlessness should be assessed and managed in the context of poor prognosis.

    Original languageEnglish
    Pages73-80
    Number of pages8
    DOIs
    Publication statusPublished - 1 Jan 2016
    EventAmerican Thoracic Society International Conference, 2016 - San Francisco, United States
    Duration: 13 May 201618 May 2016

    Conference

    ConferenceAmerican Thoracic Society International Conference, 2016
    CountryUnited States
    CitySan Francisco
    Period13/05/1618/05/16

    Keywords

    • breathlessness
    • dyspnea
    • elderly
    • end of life
    • prevalence

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  • Cite this

    Johnson, M., Bland, J., Gahbauer, E., Ekstrom, M., Sinnarajah, A., Gill, T., & Currow, D. (2016). Breathlessness in Elderly Adults during the Last Year of Life Sufficient to Restrict Activity: Prevalence, Pattern, and Associated Factors. 73-80. Paper presented at American Thoracic Society International Conference, 2016, San Francisco, United States. https://doi.org/10.1111/jgs.13865