{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:43:22Z","timestamp":1753875802946,"version":"3.41.2"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T00:00:00Z","timestamp":1693526400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100007155","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007155","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000268","name":"Biotechnology and Biological Sciences Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000268","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000377","name":"Dunhill Medical Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000377","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Institute for Health Research School for Primary Care"},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Unilever Corporate Research"},{"name":"Newcastle Primary Care Trust"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Long-term breathlessness is more common with age. However, in the oldest old (&amp;gt;85\u00a0years), little is known about the prevalence, or impact of breathlessness. We estimated breathlessness limiting exertion prevalence and explored (i) associated characteristics; and (ii) whether breathlessness limiting exertion explains clinical and social\/functional outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Health and socio-demographic characteristics were extracted from the Newcastle 85+ Study cohort. Phase 1 (baseline) and follow-up data (18\u00a0months, Phase 2; 36\u00a0months, Phase 3; 60\u00a0months, Phase 4 after baseline) were examined using descriptive statistics and cross-sectional regression models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Eight hundred seventeen participants provided baseline breathlessness data (38.2% men; mean 84.5\u00a0years; SD 0.4). The proportions with any limitation of exertion, or severe limitation by breathlessness were 23% (95% confidence intervals (CIs) 20\u201325%) and 9% (95%CIs 7\u201311%) at baseline; 20% (16\u201325%) and 5% (3\u20138%) at Phase 4. Having more co-morbidities (odds ratio (OR) 1.34, 1.18\u20131.54; P\u00a0&amp;lt;\u20090.001), or self-reported respiratory (OR 1.88, 1.25\u20132.82; P\u00a0=\u20090.003) or cardiovascular disease (OR 2.38, 1.58\u20133.58; P\u00a0&amp;lt;\u20090.001) were associated with breathlessness limiting exertion. Breathlessness severely limiting exertion was associated with poorer self-rated health (OR 0.50, 029\u20130.86; P\u2009=\u20090.012), depression (beta-coefficient 0.11, P\u2009=\u20090.001), increased primary care contacts (beta-co-efficient 0.13, P\u2009=\u20090.001) and number of nights in hospital (OR 1.81; 1.02\u20133.20; P\u2009=\u20090.042).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Breathlessness limiting exertion appears to become less prevalent over time due to death or withdrawal of participants with cardio-respiratory illness. Breathlessness severely limiting exertion had a wide range of service utilisation and wellbeing impacts.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ageing\/afad155","type":"journal-article","created":{"date-parts":[[2023,9,2]],"date-time":"2023-09-02T09:37:06Z","timestamp":1693647426000},"source":"Crossref","is-referenced-by-count":1,"title":["Breathlessness limiting exertion in very old adults: findings from the Newcastle 85+ study"],"prefix":"10.1093","volume":"52","author":[{"given":"Miriam J","family":"Johnson","sequence":"first","affiliation":[{"name":"Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull , Hull , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas","family":"Pitel","sequence":"additional","affiliation":[{"name":"Hull Health Trials Unit , Hull York Medical School, , Hull , UK"},{"name":"University of Hull , Hull York Medical School, , Hull , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David C","family":"Currow","sequence":"additional","affiliation":[{"name":"Department of Medicine and Health, University of Wollongong , Wollongong, NSW , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia","family":"Forbes","sequence":"additional","affiliation":[{"name":"Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull , Hull , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ireneous","family":"Soyiri","sequence":"additional","affiliation":[{"name":"Hull York Medical School, University of Hull , Hull , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise","family":"Robinson","sequence":"additional","affiliation":[{"name":"Population Health Sciences Institute, Newcastle University , Newcastle upon Tyne , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,9,1]]},"reference":[{"key":"2023101113122738100_ref1","doi-asserted-by":"crossref","first-page":"1602277","DOI":"10.1183\/13993003.02277-2016","article-title":"Towards an expert consensus to delineate a clinical syndrome of chronic breathlessness","volume":"49","author":"Johnson","year":"2017","journal-title":"Eur Respir J"},{"key":"2023101113122738100_ref2","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1136\/thoraxjnl-2016-209908","article-title":"Chronic breathlessness associated with poorer physical and mental health-related quality of life (SF-12) across all adult age groups","volume":"72","author":"Currow","year":"2017","journal-title":"Thorax"},{"key":"2023101113122738100_ref3","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1016\/j.jpainsymman.2020.05.015","article-title":"Quality of life changes with duration of chronic breathlessness: a random sample of community-dwelling people","volume":"60","author":"Currow","year":"2020","journal-title":"J Pain Symptom Manage"},{"key":"2023101113122738100_ref4","first-page":"166","article-title":"Activities foregone because of chronic breathlessness: a cross-sectional, population prevalence study","volume":"1","author":"Kochovska","year":"2020","journal-title":"Palliat Med J"},{"key":"2023101113122738100_ref5","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1186\/s12890-022-01861-y","article-title":"Lower workforce participation is associated with more severe persisting breathlessness","volume":"22","author":"Clark","year":"2022","journal-title":"BMC Pulm Med"},{"key":"2023101113122738100_ref6","doi-asserted-by":"crossref","first-page":"00415","DOI":"10.1183\/23120541.00415-2021","article-title":"Health service utilisation associated with chronic breathlessness: random population sample","volume":"7","author":"Currow","year":"2021","journal-title":"ERJ Open Research"},{"key":"2023101113122738100_ref7","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1111\/j.1365-2796.2006.01631.x","article-title":"Respiratory symptoms as predictors of all-cause mortality in an urban community: a 30-year follow-up","volume":"259","author":"Frostad","year":"2006","journal-title":"J Intern Med"},{"key":"2023101113122738100_ref8","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1093\/ageing\/afs049","article-title":"Dyspnoea and mortality in older people in the community: a 10-year follow-up","volume":"41","author":"Ahmed","year":"2012","journal-title":"Age Ageing"},{"key":"2023101113122738100_ref9","doi-asserted-by":"crossref","first-page":"b4904","DOI":"10.1136\/bmj.b4904","article-title":"Health and disease in 85 year olds: baseline findings from the Newcastle 85+ cohort study","volume":"339","author":"Collerton","year":"2009","journal-title":"BMJ"},{"key":"2023101113122738100_ref10","doi-asserted-by":"crossref","first-page":"2201603","DOI":"10.1183\/13993003.01603-2022","article-title":"Invisibility of persistent breathlessness in clinical consultations: a cross-sectional, national online survey","volume":"60","author":"Kochovska","year":"2022","journal-title":"Eur Respir J"},{"key":"2023101113122738100_ref11","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.resp.2011.04.011","article-title":"Sex differences in exertional dyspnea in patients with mild COPD: physiological mechanisms","volume":"177","author":"Guenette","year":"2011","journal-title":"Respir Physiol Neurobiol"},{"key":"2023101113122738100_ref12","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1586\/17476348.2014.879530","article-title":"Prevalence and assessment of breathlessness in the clinical setting","volume":"8","author":"Johnson","year":"2014","journal-title":"Expert Rev Respir Med"},{"key":"2023101113122738100_ref13","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1093\/ageing\/30.2.155","article-title":"Dyspnoea and quality of life in older people at home","volume":"30","author":"Ho","year":"2001","journal-title":"Age Ageing"},{"key":"2023101113122738100_ref14","doi-asserted-by":"crossref","first-page":"1583","DOI":"10.1152\/japplphysiol.00079.2008","article-title":"Sex differences in the perceived intensity of breathlessness during exercise with advancing age","volume":"104","author":"Ofir","year":"2008","journal-title":"J Appl Physiol (1985)"},{"key":"2023101113122738100_ref15","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.jpainsymman.2005.06.007","article-title":"A comparison of symptom prevalence in far advanced cancer, AIDS, heart disease, chronic obstructive pulmonary disease and renal disease","volume":"31","author":"Solano","year":"2006","journal-title":"J Pain Symptom Manage"},{"key":"2023101113122738100_ref16","doi-asserted-by":"crossref","first-page":"e4","DOI":"10.1016\/j.jpainsymman.2019.01.012","article-title":"Acute-on-chronic breathlessness: recognition and response","volume":"57","author":"Hutchinson","year":"2019","journal-title":"J Pain Symptom Manage"},{"key":"2023101113122738100_ref17","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1111\/jgs.13865","article-title":"Breathlessness in elderly adults during the last year of life sufficient to restrict activity: prevalence, pattern, and associated factors","volume":"64","author":"Johnson","year":"2016","journal-title":"J Am Geriatr Soc"},{"key":"2023101113122738100_ref18","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1186\/1471-2458-13-320","article-title":"The relationship between self-rated health and objective health status: a population-based study","volume":"13","author":"Wu","year":"2013","journal-title":"BMC Public Health"},{"key":"2023101113122738100_ref19","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.socscimed.2009.05.013","article-title":"What is self-rated health and why does it predict mortality? Towards a unified conceptual model","volume":"69","author":"Jylh\u00e4","year":"2009","journal-title":"Soc Sci Med"},{"key":"2023101113122738100_ref20","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1300\/J018v01n01_06","article-title":"Screening tests for geriatric depression","volume":"1","author":"Brink","year":"1982","journal-title":"Clin Gerontol"},{"key":"2023101113122738100_ref21","first-page":"387","article-title":"Balance in elderly patients: the \u201cget-up and go\u201d test","volume":"67","author":"Mathias","year":"1986","journal-title":"Arch Phys Med Rehabil"},{"key":"2023101113122738100_ref22","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/j.mehy.2014.04.011","article-title":"The biological impact of living with chronic breathlessness \u2013 a role for the hypothalamic-pituitary-adrenal axis?","volume":"83","author":"Ryan","year":"2014","journal-title":"Med Hypotheses"},{"key":"2023101113122738100_ref23","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.psyneuen.2015.07.528","article-title":"Salivary diurnal cortisol profiles in patients with advanced malignant and non-malignant disease: a cross-sectional study","volume":"61","author":"Ryan","year":"2015","journal-title":"Psychoneuroendocrinology"},{"key":"2023101113122738100_ref24","first-page":"e398","article-title":"Cortisol levels and metabolic parameters in middle- and advanced- age subjects: associations with age","volume":"34","author":"Terzidis","year":"2011","journal-title":"J Endocrinol Invest"},{"volume-title":"C Reactive Protein \u2013 StatPearls \u2013 NCBI Bookshelf (nih.gov)","year":"2022","author":"Nehring","key":"2023101113122738100_ref25"},{"key":"2023101113122738100_ref26","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1016\/j.mad.2011.08.001","article-title":"Assessment of a large panel of candidate biomarkers of ageing in the Newcastle 85+ study","volume":"132","author":"Martin-Ruiz","year":"2011","journal-title":"Mech Ageing Dev"},{"key":"2023101113122738100_ref27","doi-asserted-by":"crossref","first-page":"e31665","DOI":"10.1371\/journal.pone.0031665","article-title":"Losing the ability in activities of daily living in the oldest old: a hierarchic disability scale from the Newcastle 85+ study","volume":"7","author":"Kingston","year":"2012","journal-title":"PLoS One"},{"key":"2023101113122738100_ref28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2318-10-64","article-title":"Engaging the oldest old in research: lessons from the Newcastle 85+ study","volume":"10","author":"Davies","year":"2010","journal-title":"BMC Geriatr"},{"key":"2023101113122738100_ref29","doi-asserted-by":"crossref","first-page":"1704","DOI":"10.1378\/chest.114.6.1704","article-title":"Geriatric respiratory medicine","volume":"114","author":"Chan","year":"1998","journal-title":"Chest"},{"key":"2023101113122738100_ref30","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1183\/09031936.99.14614549","article-title":"Physiological changes in respiratory function associated with ageing","volume":"14","author":"Janssens","year":"1999","journal-title":"Eur Respir J"},{"key":"2023101113122738100_ref31","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1164\/ajrccm.149.2.8306041","article-title":"Respiratory muscle strength in the elderly. Correlates and reference values. Cardiovascular health study research group","volume":"149","author":"Enright","year":"1994","journal-title":"Am J Respir Crit Care Med"},{"key":"2023101113122738100_ref32","doi-asserted-by":"crossref","first-page":"e0190876","DOI":"10.1371\/journal.pone.0190876","article-title":"Absolute lung size and the sex difference in breathlessness in the general population","volume":"13","author":"Ekstr\u00f6m","year":"2018","journal-title":"PLoS One"},{"key":"2023101113122738100_ref33","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1164\/rccm.200901-0127OC","article-title":"Lung volume reference values for women and men 65 to 85 years of age","volume":"180","author":"Garcia-Rio","year":"2009","journal-title":"Am J Respir Crit Care Med"},{"key":"2023101113122738100_ref34","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1186\/s12939-017-0670-3","article-title":"Different indicators of socioeconomic status and their relative importance as determinants of health in old age","volume":"16","author":"Darin-Mattsson","year":"2017","journal-title":"Int J Equity Health"},{"key":"2023101113122738100_ref35","first-page":"126","article-title":"Social position and health in old age: the relevance of different indicators of social position","volume":"31","author":"Avlund","year":"2003","journal-title":"Scand J Soc Med"},{"key":"2023101113122738100_ref36","doi-asserted-by":"crossref","first-page":"e019218","DOI":"10.1136\/bmjopen-2017-019218","article-title":"Use of primary care and other healthcare services between age 85 and 90 years: longitudinal analysis of a single-year birth cohort, the Newcastle 85+ study","volume":"8","author":"Yadegarfar","year":"2018","journal-title":"BMJ Open"},{"key":"2023101113122738100_ref37","doi-asserted-by":"crossref","first-page":"100975","DOI":"10.1016\/j.retrec.2020.100975","article-title":"Mobility impact and well-being in later life: a multidisciplinary systematic review","volume":"86","author":"Pantelaki","year":"2021","journal-title":"Res Transport Econ"},{"key":"2023101113122738100_ref38","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1093\/geront\/gnq013","article-title":"Mobility in older adults: a comprehensive framework","volume":"50","author":"Webber","year":"2010","journal-title":"Gerontologist"},{"key":"2023101113122738100_ref39","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1038\/s41533-017-0024-z","article-title":"The breathing, thinking, functioning clinical model: a proposal to facilitate evidence-based breathlessness management in chronic respiratory disease","volume":"27","author":"Spathis","year":"2017","journal-title":"NPJ Prim Care Respir Med"},{"key":"2023101113122738100_ref40","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1136\/thoraxjnl-2018-211589","article-title":"Holistic services for people with advanced disease and chronic breathlessness: a systematic review and meta-analysis","volume":"74","author":"Brighton","year":"2019","journal-title":"Thorax"},{"key":"2023101113122738100_ref41","doi-asserted-by":"crossref","first-page":"1700558","DOI":"10.1183\/13993003.00558-2017","article-title":"The independent association of overweight and obesity with breathlessness in adults. A cross-sectional, population-based study","volume":"50","author":"Currow","year":"2017","journal-title":"Eur Resp J"},{"key":"2023101113122738100_ref42","doi-asserted-by":"crossref","first-page":"2035","DOI":"10.1111\/jgs.14313","article-title":"Prevalence and outcomes of breathlessness in older adults: a National Population Study","volume":"64","author":"Smith","year":"2016","journal-title":"J Am Geriatr Soc"},{"key":"2023101113122738100_ref43","doi-asserted-by":"crossref","first-page":"e000643","DOI":"10.1136\/bmjresp-2020-000643","article-title":"Underlying contributing conditions to breathlessness among middle-aged individuals in the general population: a cross-sectional study BMJ open","volume":"7","author":"Sandberg","year":"2020","journal-title":"Respir Res"},{"key":"2023101113122738100_ref44","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1093\/ije\/22.4.666","article-title":"Smoking cessation and changes in respiratory symptoms in two populations followed for 13 years","volume":"22","author":"Krzyzanowski","year":"1993","journal-title":"Int J Epidemiol"},{"key":"2023101113122738100_ref45","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/S2215-0366(20)30383-7","article-title":"Symptoms among adults aged 50 years and older: a 12-year population-based cohort study","volume":"8","author":"Lee","year":"2021","journal-title":"Lancet Psychiatry"},{"key":"2023101113122738100_ref46","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyg.2019.01329","article-title":"Driving as a travel option for older adults: findings from the Irish longitudinal study on aging","volume":"10","author":"Gormley","year":"2019","journal-title":"Front Psychol"},{"key":"2023101113122738100_ref47","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1093\/ptj\/80.9.896","article-title":"Predicting the probability for falls in community-dwelling older adults using the timed up & go test","volume":"80","author":"Shumway-Cook","year":"2000","journal-title":"Phys Ther"},{"key":"2023101113122738100_ref48","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/1471-2318-14-14","article-title":"Is the timed up and go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and meta- analysis","volume":"14","author":"Barry","year":"2014","journal-title":"BMC Geriatr"},{"key":"2023101113122738100_ref49","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1093\/gerona\/gls190","article-title":"Using timed up-and-go to identify frail members of the older population","volume":"68","author":"Savva","year":"2013","journal-title":"J Gerontol"}],"container-title":["Age and Ageing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ageing\/article-pdf\/52\/9\/afad155\/52009685\/afad155.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ageing\/article-pdf\/52\/9\/afad155\/52009685\/afad155.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T22:44:45Z","timestamp":1697064285000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ageing\/article\/doi\/10.1093\/ageing\/afad155\/7258777"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,1]]},"references-count":49,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,9,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ageing\/afad155","relation":{},"ISSN":["0002-0729","1468-2834"],"issn-type":[{"type":"print","value":"0002-0729"},{"type":"electronic","value":"1468-2834"}],"subject":[],"published-other":{"date-parts":[[2023,9,1]]},"published":{"date-parts":[[2023,9,1]]},"article-number":"afad155"}}