Relationships between self-reported dyspnea, health conditions and frailty among Brazilian community-dwelling older adults: a cross-sectional study

Abstract

CONTEXT: Dyspnea is a symptom present in several chronic diseases commonly seen among older adults. Since individuals with dyspnea tend to stay at rest, with consequently reduced levels of physical activity, they are likely to be at greater risk of developing frailty, especially at older ages. DESIGN AND SETTING: Cross-sectional study at community level, Brazil. OBJECTIVE: To analyze the relationships between self-reported dyspnea, health conditions and frailty status in a sample of community-dwelling older adults. METHOD: Secondary data from the follow-up of the Frailty in Brazilian Elderly (FIBRA) study, involving 415 community-dwelling older adults (mean age: 80.3 ± 4.68 years), were used. The variables analyzed were sociodemographic characteristics, reported dyspnea, clinical data and frailty phenotype. Associations between dyspnea and other variables (age, sex, education and body mass index) were verified through the crude (c) and adjusted (a) odds ratios. RESULTS: The prevalence of dyspnea in the entire sample was 21.0%. Dyspnea was more present in individuals with pulmonary diseases, heart disease, cancer and depression. Older adults with multimorbidities (adjusted odds ratio, ORa = 2.91; 95% confidence interval, CI = 1.41-5.99) and polypharmacy (ORa = 2.02; 95% CI = 1.15-3.54) were more likely to have dyspnea. Those who reported dyspnea were 2.54 times more likely to be frail (ORa = 2.54; 95% CI = 1.08-5.97), and fatigue was their most prevalent phenotype component. CONCLUSION: Dyspnea was associated with different diseases, multimorbidities, polypharmacy and frailty. Recognizing the factors associated with dyspnea may contribute to its early identification and prevention of its negative outcomes among older adults.

Global challenges in aging: insights from comparative biology and one health

“…This appears to be due to declines in natural immunity, increased vulnerability to adverse drug reactions, decreased organ function, and increases in comorbidity factors with age, among other possible factors ( Biswas et al, 2021 ). Younger individuals who have been infected with COVID-19 may also experience long-term effects including fatigue, hair loss, attention disorders, and dyspnea ( Lopez-Leon et al, 2021 ), which are also associated with aging (e.g., Lufi et al, 2015 ; Buarque et al, 2022 ) and possibly an indicator of accelerated biological aging. Similarly, aged non-human vertebrates can also exhibit elevated vulnerability to disease due to immunosenescence ( Lavoie et al, 2007 ) and/or increased exposure to vectors of disease ( Bennett and Fallis, 1960 ).…”

Breathlessness in older adults: What we know and what we still need to know

“…38,39 Community-dwelling older adults with dyspnea have higher prevalence of multimorbidity, medication use and/or polypharmacy. 4,16,19,22,62 Comorbidities and polypharmacy may contribute to both the peripheral and central processing of breathlessness and influence its perception and reporting in community-dwelling older adults so their role needs to be further researched. 16,19,62 Future research on the impact of aging-related changes, especially cognitive-affective ones, on the perception and self-reporting of breathlessness in community-dwelling older adults would help the development of more appropriate tools to assess and address their burden of breathlessness.…”

“…Community‐dwelling older adults with dyspnea have higher prevalence of multimorbidity, medication use and/or polypharmacy 4,16,19,22,62 . Comorbidities and polypharmacy may contribute to both the peripheral and central processing of breathlessness and influence its perception and reporting in community‐dwelling older adults so their role needs to be further researched 16,19,62 …”