Disability and long-term breathlessness: a cross-sectional, population study

Abstract

IntroductionDisability, resulting from altered interactions between individuals and their environment, is a worldwide issue causing inequities and suffering. Many diseases associated with breathlessness cause disability but the relationship between disability and the severity of breathlessness itself is unknown.This study evaluated associations between disability using the WHO’s Disability Assessment Schedule (WHODAS) 2.0 and levels of long-termbreathlessness limiting exertion.MethodsThis population-based, cross-sectional online survey (n=10 033) reflected the most recent national census (2016) by age, sex, state/territory of residence and rurality. Assessments included self-reported disability (WHODAS 2.0 12-item (range 12 (no disability) to 60 (most severe disability)) assessed in 6 domains) and long-termbreathlessness limiting exertion(modified Medical Research Council (mMRC) breathlessness scale; 0–4 (4—most severe)). Days in the last month affected by breathlessness were reported.ResultsOf respondents (52% women; mean age 45), mean total disability score was 20.9 (SD 9.5). 42% (n=4245) had mMRC >0 (mMRC1 31% (n=3139); mMRC2 8% (n=806); mMRC3,4 3% (n=300)). Every level of long-termbreathlessness limiting exertionwas associated with greater levels of disability (total p <0.001; each domain p <0.001). The most compromised domains wereMobilityandParticipation.In the last 30 days, people with severe breathlessness (mMRC 3–4): experienced disability (20 days); reduced activities/work (10 days); and completely forwent activities (another 5 days).ConclusionsDisability should be in the definition of persistent breathlessness as it is systematically associated with long-termbreathlessness limiting exertionin a grade-dependent, multidimensional manner. Disability should be assessed in people with long-term breathlessness to optimise their social well-being and health.