Young, Carolyn A 
ORCID: 0000-0001-6971-8203, Chaouch, Amina, Mcdermott, Christopher J, Al-Chalabi, Ammar, Chhetri, Suresh K, Talbot, Kevin, Harrower, Timothy, Orrell, Richard W, Annadale, Joe, Hanemann, C Oliver et al (show 4 more authors)
(2024)
Dyspnea (breathlessness) in amyotrophic lateral sclerosis/motor neuron disease: prevalence, progression, severity, and correlates.
Amyotrophic lateral sclerosis & frontotemporal degeneration, ahead- (ahead-).
pp. 1-11.
Abstract
<i>Objective</i>: Dyspnea, or breathlessness, is an important symptom in amyotrophic lateral sclerosis/motor neuron disease (ALS/MND). We examined the measurement properties of the Dyspnea-12. <i>Methods</i>: Rasch analysis enabled conversion of raw Dyspnea-12 scores to interval level metric equivalents. Converted data were used to perform trajectory modeling; those following different trajectories were compared for demographic, clinical, symptom, and functioning characteristics. Logistic regression examined differences between distinct trajectories. <i>Results</i>: In 1022 people, at baseline, mean metric Dyspnea-12 was 7.6 (SD 9.3). 49.8% had dyspnea, severe in 12.6%. Trajectory analysis over 28 months revealed three breathlessness trajectories: group 1 reported none at baseline/follow-up (42.7%); group 2 significantly increased over time (9.4%); group 3 had a much higher level at baseline which rose over follow-up (47.9%). Group 3 had worse outcomes on all symptoms, functioning and quality of life; compared to group 1, their odds of: respiratory onset sixfold greater; King's stage ≥3 2.9 greater; increased odds of being bothered by choking, head drop, fasciculations, and muscle cramps; fatigue and anxiety also elevated (<i>p</i> < .01). <i>Conclusion</i>: Dyspnea is a cardinal symptom in ALS/MND and can be quickly measured using the Dyspnea-12. Raw scores can easily be converted to interval level measurement, for valid change scores and trajectory modeling. Dyspnea trajectories reveal different patterns, showing that clinical services must provide monitoring which is customized to individual patient need. Almost half of this large population had worsening dyspnea, confirming the importance of respiratory monitoring and interventions being integrated into routine ALS care.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | TONIC-ALS STUDY GROUP |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 15 Apr 2024 09:19 |
| Last Modified: | 15 Apr 2024 09:41 |
| DOI: | 10.1080/21678421.2024.2322545 |
| Open Access URL: | https://doi.org/10.1080/21678421.2024.2322545 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3180325 |
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