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Diminishing activities of daily living as severity of chronic breathlessness worsens : a national, cross-sectional survey

Kochovska, Slavica ; Chang, Sungwon ; Ferreira, Diana ; Brunelli, Vanessa ; Macdonald, Jessica ; San, Hiu ; Olsson, Max LU orcid ; Sandberg, Jacob LU orcid ; Luckett, Tim and Johnson, Miriam J , et al. (2025) In BMJ Open Respiratory Research 12.
Abstract

INTRODUCTION: Effective management of chronic breathlessness requires understanding people's activity limitations. This study evaluated the extent to which chronic breathlessness limits people's self-reported everyday activities.

METHODS: A web-based, cross-sectional survey (adults ≥18 years). Recruitment was through a marketing research company, stratified to the 2016 Australian Census for key demographics (age, sex, state/territory of residence, rurality). Self-reported measures included demographics, breathlessness limiting exertion (modified Medical Research Council (mMRC) breathlessness scale) and breathlessness impact (yes/no question; three most important activities affected). Impact was categorised as performing with... (More)

INTRODUCTION: Effective management of chronic breathlessness requires understanding people's activity limitations. This study evaluated the extent to which chronic breathlessness limits people's self-reported everyday activities.

METHODS: A web-based, cross-sectional survey (adults ≥18 years). Recruitment was through a marketing research company, stratified to the 2016 Australian Census for key demographics (age, sex, state/territory of residence, rurality). Self-reported measures included demographics, breathlessness limiting exertion (modified Medical Research Council (mMRC) breathlessness scale) and breathlessness impact (yes/no question; three most important activities affected). Impact was categorised as performing with difficulty/reduced/ceased.

RESULTS: 7300 respondents were included (mean age 46.5 (SD 18.6); men 50.8%; mMRC ≥1 290.0%). 30.6% (648/2119) with mMRC ≥1 versus 2.6% (136/5181; p<0.001) with mMRC 0 reported activities affected; the proportions increased for each mMRC level.2342 activities were nominated with the most frequent being: high intensity sport, household chores and mobility. The order changed for mMRC 2 (household chores>high intensity sports>mobility) and mMRC 3-4 (mobility>household chores>high intensity sports). Breathlessness increased the likelihood of activities being reduced or ceased.In a logistic regression model exploring the WHO Disability Assessment Schedule, controlling for baseline factors, most affected domains were getting along (OR 2.5 (95% CI 1.5 to 4.2)), life activities (OR 1.8 (95% CI 1.2 to 2.7)) and participation (OR 6.4 (95% CI 4.2 to 9.9)).

CONCLUSION: Chronic breathlessness of every intensity above mMRC 0 affects people's ability to perform a range of everyday activities. The progressive loss of these activities is a key coping mechanism to avoid precipitating breathlessness and is mostly invisible to other people.

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Contribution to journal
publication status
published
subject
keywords
Humans, Male, Dyspnea/physiopathology, Cross-Sectional Studies, Female, Activities of Daily Living, Middle Aged, Adult, Australia/epidemiology, Chronic Disease, Aged, Severity of Illness Index, Self Report
in
BMJ Open Respiratory Research
volume
12
article number
e003339
publisher
BMJ Publishing Group
external identifiers
  • pmid:41407392
  • scopus:105025171387
ISSN
2052-4439
DOI
10.1136/bmjresp-2025-003339
language
English
LU publication?
yes
additional info
© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.
id
c7750f97-1368-4045-a26c-0c9ff2ffc16e
date added to LUP
2026-01-23 08:43:37
date last changed
2026-01-24 04:01:09
@article{c7750f97-1368-4045-a26c-0c9ff2ffc16e,
  abstract     = {{<p>INTRODUCTION: Effective management of chronic breathlessness requires understanding people's activity limitations. This study evaluated the extent to which chronic breathlessness limits people's self-reported everyday activities.</p><p>METHODS: A web-based, cross-sectional survey (adults ≥18 years). Recruitment was through a marketing research company, stratified to the 2016 Australian Census for key demographics (age, sex, state/territory of residence, rurality). Self-reported measures included demographics, breathlessness limiting exertion (modified Medical Research Council (mMRC) breathlessness scale) and breathlessness impact (yes/no question; three most important activities affected). Impact was categorised as performing with difficulty/reduced/ceased.</p><p>RESULTS: 7300 respondents were included (mean age 46.5 (SD 18.6); men 50.8%; mMRC ≥1 290.0%). 30.6% (648/2119) with mMRC ≥1 versus 2.6% (136/5181; p&lt;0.001) with mMRC 0 reported activities affected; the proportions increased for each mMRC level.2342 activities were nominated with the most frequent being: high intensity sport, household chores and mobility. The order changed for mMRC 2 (household chores&gt;high intensity sports&gt;mobility) and mMRC 3-4 (mobility&gt;household chores&gt;high intensity sports). Breathlessness increased the likelihood of activities being reduced or ceased.In a logistic regression model exploring the WHO Disability Assessment Schedule, controlling for baseline factors, most affected domains were getting along (OR 2.5 (95% CI 1.5 to 4.2)), life activities (OR 1.8 (95% CI 1.2 to 2.7)) and participation (OR 6.4 (95% CI 4.2 to 9.9)).</p><p>CONCLUSION: Chronic breathlessness of every intensity above mMRC 0 affects people's ability to perform a range of everyday activities. The progressive loss of these activities is a key coping mechanism to avoid precipitating breathlessness and is mostly invisible to other people.</p>}},
  author       = {{Kochovska, Slavica and Chang, Sungwon and Ferreira, Diana and Brunelli, Vanessa and Macdonald, Jessica and San, Hiu and Olsson, Max and Sandberg, Jacob and Luckett, Tim and Johnson, Miriam J and Ekström, Magnus and Currow, David}},
  issn         = {{2052-4439}},
  keywords     = {{Humans; Male; Dyspnea/physiopathology; Cross-Sectional Studies; Female; Activities of Daily Living; Middle Aged; Adult; Australia/epidemiology; Chronic Disease; Aged; Severity of Illness Index; Self Report}},
  language     = {{eng}},
  month        = {{12}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ Open Respiratory Research}},
  title        = {{Diminishing activities of daily living as severity of chronic breathlessness worsens : a national, cross-sectional survey}},
  url          = {{http://dx.doi.org/10.1136/bmjresp-2025-003339}},
  doi          = {{10.1136/bmjresp-2025-003339}},
  volume       = {{12}},
  year         = {{2025}},
}