Breathlessness catastrophizing and influencing factors study of elderly COPD patients: A latent profile analysis

Chronic obstructive pulmonary disease (COPD) ranks among the leading global causes of death, with elderly patients facing heightened risks due to age-related declines in lung function. Breathlessness catastrophizing (BC), a negative cognitive response to dyspnea including rumination, magnification. Understanding the heterogeneity of BC in elderly COPD patients is essential for developing targeted interventions.

The objective of this study was to identify subgroups of elderly COPD patients with breathlessness catastrophizing through latent profile analysis (LPA) and to explore the related influencing factors.

The data of 225 elderly patients with COPD were collected and analyzed. The collected data included the demographic and clinical factors, and the patients were assessed with the Breathlessness Catastrophizing Scale(BCS), the COPD Self-Efficacy Scale(CSES) and the Ruminative Response Scale(RRS).

The study identified three breathlessness catastrophizing subgroups: Low Breathlessness Catastrophizing Type(44.4%), Moderate Breathlessness Catastrophizing Type(25.8%), and High Breathlessness Catastrophizing Type(29.8%). Three factors were significantly associated with subgroups: number of COPD exacerbations in the past year, COPD self-efficacy, and rumination response (all p<0.05). Education level and daily steps significantly influenced the low breathlessness catastrophizing type (all p<0.05).

Elderly COPD patients exhibit heterogeneity in breathlessness catastrophizing patterns. Factors including low education levels, frequent acute exacerbations, physical inactivity, diminished self-efficacy, and excessive rumination significantly increase the risk of severe breathlessness catastrophizing. Intervention strategies should prioritize enhancing self-efficacy, managing rumination, promoting physical activity, and implementing personalized approaches for different subgroups with breathlessness catastrophizing. Multidisciplinary collaboration is essential for reducing breathlessness catastrophizing and improving health outcomes.