Dyspnea during daily activities predicts all-cause mortality

Dyspnea, a sensation of breathlessness, during light daily activities can be used as an indicator of exercise intolerance and low fitness. According to a study on Finnish twins, persistent or developing dyspnea reveals an increased risk of death.

The on Finnish twins revealed that all-cause mortality increased along the degree of dyspnea during the 28-year follow-up. In the study, twin individuals with persistent dyspnea (dyspnea noticed in 1975 and 1981) and dyspnea developers (dyspnea noticed in 1981) had an increased risk of (hazard ratio [HR] 1.41, 95% CI 1.31–1.52 and 1.16, 1.05–1.25 respectively) compared to asymptomatic individuals. Easy shortness of breath also indicated an increased risk of death among individuals considered healthy at the 1981 baseline.

To eliminate genetic background effects, within-pair analyses were conducted among pairs that were discordant for dyspnea and mortality rate. These analyses showed an increased risk of death also among discordant pairs: twins with persistent dyspnea had an increased risk of death compared to their asymptomatic co-twins (HR 1.47, 1.23–1.77). Respectively, a risk difference was seen in the pairwise analysis among healthy monozygotic discordant for dyspnea (HR 2.64, 95% CI 1.21–5.74).

The study was a collaborative effort of the universities of Jyväskylä and Helsinki and was conducted among all same-sex twin pairs born in Finland before 1958. Dyspnea was measured with a modified Medical Research Council (mMRC) scale. The scale includes four questions on the degree of dyspnea when walking and performing daily tasks (e.g. do you usually get short of breath when you walk uphill, climb stairs, when walking on level ground). The level and change in dyspnea between 1975 and 1981 were used to predict mortality during a 28-year follow up (between 1981 and 2010). In total 21,379 twin individuals (including 8,672 complete twin pairs) were studied.

The study shows that persistent dyspnea (breathlessness) predicts increased mortality during a 28-year follow-up even among individuals without a clinically overt disease known to associate with dyspnea. Based on the results, we believe that the score, which can be easily obtained and correlates with fitness outcomes, could be a screening tool for identifying unfit individuals at an increased risk.

More information: Waller K, Kaprio J, Kujala UM. "Dyspnea and All-Cause Mortality: 28-Year Follow-up Study among Adult Twins." Med Sci Sports Exerc. 2014, Feb 4. www.ncbi.nlm.nih.gov/pubmed/24500534

add to favorites email to friend print save as pdf

Related Stories

RELAX-AHF shows first positive findings in HFpEF patients

May 26, 2013

Serelaxin may be more effective for relieving dyspnea in heart failure with preserved ejection fraction (HFpEF) than reduced (HFrEF) during the first 24 hours, according to results from RELAX-AHF presented in today's late ...

Recommended for you

Obama addresses West Africans on facts about Ebola

2 hours ago

President Barack Obama urged West Africans on Tuesday to wear gloves and masks when caring for Ebola patients or burying anyone who died of the disease. He also discouraged the traditional burial practice ...

Gluten-free diet benefits asymptomatic EmA+ adults

2 hours ago

(HealthDay)—Asymptomatic individuals with endomysial antibodies (EmA) benefit from a gluten-free diet (GFD), according to a study published in the September issue of Gastroenterology.

Another US health worker infected with Ebola

2 hours ago

A third American health worker has tested positive for the Ebola virus while working with patients in West Africa, the Christian missionary group SIM said Tuesday.

UN implores all countries to help on Ebola

4 hours ago

The international group Doctor Without Borders warned Tuesday that the world is 'losing the battle' against Ebola, while U.N. officials implored all countries to quickly step up their response by contributing health experts ...

Travel restrictions could worsen Ebola crisis: experts

8 hours ago

Travel restrictions could worsen West Africa's Ebola epidemic, limiting medical and food supplies and keeping out much-needed doctors, virologists said Tuesday as the disease continued its deadly spread.

User comments