J Am Geriatr Soc. 2016 Jan;64(1):73-80.
Johnson MJ, Bland JM, Gahbauer EA et al
To investigate the relationship between age, clinical characteristics and breathlessness during the last year of life, a secondary data analysis of a US based longitudinal cohort study in people aged 70 and older in the community who had died was performed. The primary outcome was the proportion of months of restricting breathlessness (defined as at least half a day a month in bed or reduction in usual activities) reported during the last year of life; collected monthly using telephone interviews. Breathlessness data were available for 548 of 589 (93%) participants (with cancer, dementia, organ failure and frailty); 311 (57%) reported restricting breathlessness on at least one occasion during the last year of life. Although no participant reported it every month it was more frequent in the last 3 months of life and was associated with anxiety and mobility difficulties. The authors suggest that breathlessness might not be caused by aging alone, in the absence of other pathology, and that breathlessness seems to occur across many illnesses in the last months of life. In view of this association, breathlessness should be assessed and managed in the possible context of the patient having a poor prognosis.
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