A58-19 Chronic Dyspnoea Profiling: A Cluster Analysis in the Population-based Constances Cohort

Background

Chronic dyspnoea is a common condition, characterised by complex interactions between determinants. Therefore, we applied unsupervised methods among dyspnoeic adults to identify distinct profiles based on clinical, functional, and sociodemographic factors.

Methods

Data from the largest French population-based cohort CONSTANCES were used. A factorial analysis of mixed data (25 variables covering: demographic, socioeconomic, and clinical/functional characteristics, behavioural/environmental exposures, blood biomarkers) was followed by k-means clustering. Logistic models assessed associations between clusters and mMRC scale, health-related limitation and physical activity

Results

Among 114,346 participants with spirometry, mMRC dyspnoea grade, and smoking data, 24,165 (21.2%) reported chronic dyspnoea (mMRC ≥1). Among the 15,282 without missing data, three profiles were identified: C1 (n = 6,951, 45.5%) characterised by middle-aged healthier women from higher socioeconomic backgrounds; C2 (n = 4,207, 27.5%) characterised by younger socially disadvantaged women with multiple lifestyle-related risks, including smoking, at risk alcohol consumption, and obesity; and C3 (n = 4,124, 27.0%) characterised by older men with multiple cardiovascular comorbidities, impaired lung function, and high environmental and occupational exposures.Compared with C1, perceived dyspnoea severity (mMRC≥2) was more associated with C2 (OR 1.55 [1.43-1.67]) than with C3 (OR 1.20 [1.11-1.30]). Conversely, health-related limitation, was more associated with C3 (OR 2.07 [1.92-2.24]) than with C2 (OR 1.48 [1.37-1.60]). C2 had lower odds of achieving sufficient physical activity (defined as ≥ 4/6 on a composite scale of weekly manual tasks, sports, and active transportation) (OR 0.73 [0.68-0.80]), whereas C3 did not differ from C1.

Conclusion

Three distinct multifactorial profiles were identified, with characteristics highlighting the mismatch between perceived dyspnoea and functional limitation. Younger disadvantaged participants showed lower physical activity, suggesting that sedentary behaviour may contribute to chronic dyspnoea.

This abstract is funded by: INSERM- French national health and medical research body