Validity and reliability of the Multidimensional Dyspnoea Profile in older adults

Abstract

Breathlessness is a common and distressing symptom in older adults and an independent predictor of adverse outcomes. Yet, its multidimensional assessment has not been validated in older adults. We apply and validate the Multidimensional Dyspnoea Profile (MDP) in a sample of adults 75 years and older in Belgium.Breathlessness was rated with the MDP, modified Borg dyspnoea scale, numerical rating scale for intensity and unpleasantness both before and after exertion (the short battery of physical performance tests (SPPB)), as well as with the Medical Research Council dyspnoea scale. The Hospital Anxiety and Depression Scale (HADS) assessed the affective status. Factor structure was analysed with exploratory principal components analysis, internal consistency with Cronbach's alpha and concurrent validity with Spearman's correlation coefficients with other breathlessness scales, HADS and SPPB scores.In 96 participants (mean age: 85 years; 34% men) who rated breathlessness at both assessment points, exploratory principal components analysis identified two components: immediate perception (IP) and emotional reaction (ER) explaining most of MDP item variance (65.37% before and 71.32% after exertion). Internal consistency was moderate to high for MDP-IP (Cronbach's alpha=0.86 before and 0.89 after exertion) and MDP-ER (Cronbach's alpha= 0.89 before and 0.91 after exertion). The correlation patterns of MDP-IP and MDP-ER with other tests confirmed concurrent validity.The domain structure, reliability and concurrent validity of MDP for breathlessness before and after exertion were confirmed in a sample of adults 75 years and older, supporting its use and further research for the multidimensional profiling of breathlessness in older adults.

Dyspnoea-12 and Multidimensional Dyspnea Profile: Systematic Review of Use and Properties

“…Factor structure and internal consistency Psychometric aspects were available with 27 datasets (D-12 n=17 or MDP n=10), including the original development studies [4,77] and language translations (D-12 n= 8, MDP n= 3) (Supplemental materials Table S4). The two-factor structure was confirmed by five independent studies for the D-12 [7,20,33,43,44] and six independent studies for the MDP [7,57,61,69,86,87]. [Figure 1]…”

How to Assess Breathlessness in Chronic Obstructive Pulmonary Disease

“…79 The MDP has been translated into a range of languages and is validated in the laboratory setting, 77 and in patients in the emergency department 77,85 and in outpatients with cardiorespiratory disease 80,83,86 as well as in elderly people aged 75+ years. 87 The D-12 has been validated in COPD as well as a wide range of different heart-and lung diseases. 78,[81][82][83] The MDP and D-12 have demonstrated similar strength of associations with measures of HRQoL (Hospital Anxiety and Depression Scale, Chronic Respiratory Disease Questionnaire) and the mMRC.…”

Validation of the Dyspnoea-12 and Multidimensional Dyspnea profile among older Swedish men in the population

“…However, knowledge is limited on the psychometric properties of the D12 and MDP in larger populational studies of older adults [ 9 , 14 ]. To date, validation studies of D12 and MDP were conducted mainly in disease selected cohorts [ 9 ].…”

“…To date, validation studies of D12 and MDP were conducted mainly in disease selected cohorts [ 9 ]. One study [ 14 ] used a small sample to validate the MDP among older adults, however, the sample was not drawn from the general older population. The distribution of breathlessness dimensions in the previous validation studies are unbalanced, and mainly include participants with severe breathlessness and chronical diseases, such as chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) [ 9 ].…”