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Open Access Research article

Predictors of chronic breathlessness: a large population study

Jacqueline A Bowden1*, Timothy HM To23, Amy P Abernethy34 and David C Currow35

Author Affiliations

1 Cancer Council, South Australia, 202 Greenhill Rd, Parkside, South Australia, Australia

2 Southern Adelaide Palliative Services, Repatriation General Hospital, 700 Goodwood Rd, Daw Park, South Australia, 5041, Australia

3 Discipline of Palliative and Supportive Services, Flinders University, Sturt Road, Bedford Park, South Australia, 5042, Australia

4 Division of Medical Oncology, Department of Medicine, Duke University Medical Centre, Durham, North Carolina, 27710, USA

5 Centre for Clinical Change, School of Medicine, Flinders University, Sturt Road, Bedford Park, South Australia,5042, Australia

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BMC Public Health 2011, 11:33  doi:10.1186/1471-2458-11-33

Published: 12 January 2011



Breathlessness causes significant burden in our community but the underlying socio-demographic and lifestyle factors that may influence it are not well quantified. This study aims to define these predictors of chronic breathlessness at a population level.


Data were collected from adult South Australians in 2007 and 2008 (n = 5331) as part of a face-to-face, cross-sectional, whole-of-population, multi-stage, systematic area sampling population health survey. The main outcome variable was breathlessness in logistic regression models. Lifestyle factors examined included smoking history, smoke-free housing, level of physical activity and body mass index (obesity).


The participation rate was 64.1%, and 11.1% of individuals (15.0% if aged ≥50 years) chronically had breathlessness that limited exertion. Significant bivariate associations with chronic breathlessness for the whole population and only those ≥50 included: increasing age; female gender; being separated/divorced/widowed; social disadvantage; smoking status; those without a smoke-free home; low levels of physical activity; and obesity. In multi-variate analyses adjusted for age, marital status (p < 0.001), physical activity (p < 0.001), obesity (p < 0.001), gender (p < 0.05) and social disadvantage (p < 0.05) remained significant factors. Smoking history was not a significant contributor to the model.


There is potential benefit in addressing reversible lifestyle causes of breathlessness including high body mass index (obesity) and low levels of physical activity in order to decrease the prevalence of chronic breathlessness. Clinical intervention studies for chronic breathlessness should consider stratification by body mass index.