Correlates of resting and exertional dyspnea among older adults with obstructive lung disease: a cross-sectional analysis of the Canadian Longitudinal Study on Aging

Abstract

Introduction

In patients with chronic obstructive pulmonary disease (COPD), the perception of dyspnea is related to quality of life, and is a better predictor of mortality than the severity of airway obstruction. The purpose of the current study was to use population-level data from the Canadian Longitudinal Study on Aging (CLSA) to identify potential correlates of dyspnea in adults with obstructive lung disease.

Methods

Data from participants with a self-reported obstructive lung disease (asthma or COPD) were used for analysis (n=2,854). Four outcome variables were assessed: self-reported dyspnea at 1) rest, 2) walking on a flat surface, 3) walking uphill/climbing stairs, 4) following strenuous activity. Potential sociodemographic, health, and health behaviour correlates were entered in to logistic regression models.

Results

Higher body fat percentage, and worse forced expiratory volume in one second were associated with higher odds of reporting dyspnea. Females with an anxiety disorder (OR=1.91, CI: 1.29, 2.83) and males with a mood disorder (OR=2.67, CI: 1.53, 4.68) reported higher odds of experiencing dyspnea walking on a flat surface, independent of lung function and other correlates. Dyspnea while walking uphill/climbing stairs was associated with a slower timed up and go time in females (e.g. OR=1.18, CI: 1.10) and males (OR=1.19, CI: 1.09, 1.30).

Conclusions

In addition to traditional predictors such as lung function and body composition, we found that anxiety and mood disorders, as well as functional fitness were correlates of dyspnea. Further research is needed to understand whether targeting these correlates leads to improvements in perceptions of dyspnea.