Quality of life associated with breathlessness in the multinational Burden of Obstructive Lung Disease (BOLD) study: A cross-sectional analysis

Müller A 1 , Wouters EFM 1 , Burney P 2 , Potts J 2 , Cardoso J 3 , Al Ghobain M 4 Show all authors , Studnicka M 5 , Obaseki D 6 , Elsony A 7 , Mortimer K 8 , Mannino D 9 , Jõgi R 10 , Ahmed R 7 , Nafees A 11 , Rodrigues MF 12 , Bárbara C 13 , Nielsen R 14 , Gíslason T 15 , Cherkaski HH 16 , El Rhazi K 17 , Janson C 18 , Anand MP 19 , Juvekar S 20 , Dias HB 21 , Franssen FME 22 , Agarwal D 20 , Hartl S 1 , Seemungal T 23 , Paraguas SN 24 , Harrabi I 25 , Denguezli M 26 , Rashid A 27 , Erhabor G 6 , Biaze ME 28 , Koul P 29 , Janssen DJA 30 , Amaral AFS 2 , BOLD Collaborative Research Group

Affiliations 

  • 1 Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
  • 2 National Heart and Lung Institute, Imperial College London, London, UK
  • 3 Pulmonology Department, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
  • 4 King Abdullah International Medical Research Center, King Saud ben Abdulaziz University for Health Science, Riyadh, Saudi Arabia
  • 5 Department of Respiratory Medicine, University Hospital, Paracelsus Medical University, Salzburg, Austria
  • 6 Department of Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria
  • 7 The Epidemiological Laboratory, Khartoum, Sudan
  • 8 University of Cambridge, Cambridge, UK
  • 9 University of Kentucky, Lexington, KY, USA
  • 10 Lung Clinic, Tartu University Hospital, Tartu, Estonia
  • 11 Aga Khan University, Karachi, Pakistan
  • 12 Pulmonology Department, Santa Maria Local Health Unit, Lisbon, Portugal
  • 13 Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
  • 14 Department of Clinical Science, University of Bergen, Bergen, Norway
  • 15 Faculty of Medicine, University of Iceland, Reykjavik, Iceland
  • 16 Department of Pneumology, Faculty of Medicine, University Badji Mokhtar of Annaba, Annaba, Algeria
  • 17 Department of Epidemiology and Public Health, Epidemiology and Research in Health Sciences Laboratory, Faculty of Medicine, Pharmacy and Dentistry, Sidi Mohamed Ben Abdillah University, Hassan II University Hospital Center of Fes, Fes, Morocco
  • 18 Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
  • 19 Department of Respiratory Medicine, JSS Medical College, JSSAHER, Mysore, India
  • 20 Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
  • 21 Lisbon School of Health Technology, Polytechnic of Lisbon, Lisbon, Portugal
  • 22 Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
  • 23 Faculty of Medical Sciences, University of West Indies, St Augustine, Trinidad and Tobago
  • 24 Philippine College of Chest Physicians, Manila, Philippines
  • 25 Ibn El Jazzar Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
  • 26 Faculté de Médecine de Sousse, Université de Sousse, Sousse, Tunisia
  • 27 Royal College of Surgeons in Ireland and University College Dublin Malaysia Campus, Penang, Malaysia
  • 28 Department of Respiratory Medicine, Faculty of Medicine, Mohammed Ben Abdellah University, Fes, Morocco
  • 29 Department of Pulmonary Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
  • 30 Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
Pulmonology, 2025 Dec 31;31(1):2470566.
PMID: 40171577 DOI: 10.1080/25310429.2025.2470566

Abstract

INTRODUCTION: Evidence of an association between breathlessness and quality of life from population-based studies is limited. We aimed to investigate the association of both physical and mental quality of life with breathlessness across several low-, middle- and high-income countries.

METHODS: We analysed data from 19 714 adults (31 sites, 25 countries) from the Burden of Obstructive Lung Disease (BOLD) study. We measured both mental and physical quality of life components using the SF-12 questionnaire, and defined breathlessness as grade ≥2 on the modified Medical Research Council scale. We used multivariable linear regression to assess the association of each quality-of-life component with breathlessness. We pooled site-specific estimates using random-effects meta-analysis.

RESULTS: Both physical and mental component scores were lower in participants with breathlessness compared to those without. This association was stronger for the physical component (coefficient = -7.59; 95%CI -8.60, -6.58; I2 = 78.5%) than for the mental component (coefficient = -3.50; 95%CI -4.36, -2.63; I2 = 71.4%). The association between physical component and breathlessness was stronger in high-income countries (coefficient = -8.82; 95%CI -10.15, -7.50). Heterogeneity across sites was partly explained by sex and tobacco smoking.

CONCLUSION: Quality of life is worse in people with breathlessness, but this association varies widely across the world.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

MeSH terms
Similar publications