Impacts On Everyday Activities Change With Breathlessness Duration: Exploratory Population Data

To the Editor:
Chronic breathlessness, defined as “breathlessness that persists despite optimal treatment of the underlying pathophysiology and that results in disability”, is a debilitating symptom prevalent in people with life-limiting illnesses, reduces everyday activities and quality of life (QoL). A vicious cycle of breathlessness, exertion avoidance and deconditioning can lead to exponential decreases of function and QoL over time. At the same time, patients’ appraisal of QoL can sometimes improve over time even as their activities reduce because people adapt to changing circumstances, sometimes termed “response shift” in the psychometric literature. Population data indicate that individuals living with breathlessness for >20 years report better QoL than those who had breathlessness for a shorter period (between 2 and 6 years)—perhaps an example of the “disability paradox.” However, does a similar association exist between the symptom’s duration and its perceived impact on everyday activities? Research to date has not examined this question...