Relevance of multidimensional dyspnea assessment in the context of pulmonary rehabilitation.

Objectives: While dyspnea is the main symptom in chronic obstructive pulmonary disease (COPD), it is often inadequately evaluated in pulmonary rehabilitation (PR), as it is typically measured using only the impact dimension (ID). However, dyspnea is a multidimensional construct including perception (PD) and emotional (ED) domains. Our work aimed to study the complementarity of dyspnea dimensions and their respective ability to identify different evolutions during PR. Methods: 145 people with COPD attending PR were included in this retrospective study. Dyspnea scores from the modified Medical Research Council scale (ID) and the Multidimensional Dyspnea Profile questionnaire (PD/ED), exercise capacity, quality of life at the start (T1) and the end of PR (T2) were collected from existing databases/medical files. The evolution of each dyspnea dimension was evaluated using the delta score between T2-T1. PR response was defined using the minimal clinically important difference. Results: Our results show that each dyspnea dimension was associated with different health-outcomes. Positive correlations were found between PD-ED at baseline and between their T2-T1 delta score (ρ = 0.51; ρ = 0.41 respectively, p < .01), but there was no significant correlation between ID-PD or -ED (p > .05). 51% of the patients did not respond on ID, but 85% of them nonetheless responded on either PD or ED. Finally, 92% of patients responded on at least one dimension after PR. Discussion: Our study emphasizes the significance of assessing each dimension of dyspnea independently and complementary, as dimensions are associated with different elements and evolve differently under PR effects. This approach is crucial to identifying weak points and allows professionals to focus on program elements that most effectively address the specific dimension causing problems.

Personality associations with lung function and dyspnea: Evidence from six studies.

OBJECTIVE: The present study examined the association between Five Factor Model personality traits and lung function and dyspnea. METHODS: Participants were middle aged and older adults aged 34-103 years old (N > 25,000) from the Midlife in the United States Study (MIDUS), the Health and Retirement Study (HRS), the English Longitudinal Study of Ageing (ELSA), the National Health and Aging Trends Survey (NHATS), and the Wisconsin Longitudinal Study graduate (WLSG) and sibling (WLSS) samples. Data on peak expiratory flow (PEF), dyspnea, personality traits, smoking, physical activity, body mass index (BMI), emotional/psychiatric problems, and demographic factors were obtained in each sample. RESULTS: A meta-analysis indicated that higher neuroticism was related to lower PEF, higher risk of PEF less than 80% of predicted value, and higher risk of dyspnea. In contrast, higher extraversion and conscientiousness were associated with higher PEF, lower likelihood of PEF lower than 80% of the predicted value, and lower risk of dyspnea. Higher openness was related to higher PEF and lower risk of PEF less than 80%, whereas agreeableness was related to higher PEF and lower risk of dyspnea. Smoking, physical activity, BMI and emotional/psychiatric problems partially accounted for these associations. There was little evidence that lung disease moderated the association between personality and PEF and dyspnea. CONCLUSIONS: Across cohorts, this study found replicable evidence that personality is associated with lung function and associated symptomatology.

Personality and change in physical activity across 3-10 years.

OBJECTIVE: To examine the association between personality traits, defined by the Five-Factor Model, and the initiation and termination of physical activity across adulthood. DESIGN: Longitudinal analysis of participants from nine samples (N > 28,000). MAIN OUTCOME MEASURES: Physical activity status at follow-up. RESULTS: A random-effect meta-analysis revealed that higher conscientiousness, extraversion, and openness were related to a higher likelihood of initiation of physical activity over time among individuals who were physically inactive at baseline and to a lower risk of termination of physical activity among those who were physically active at baseline. In contrast, higher neuroticism was associated with a lower probability of initiation of physical activity and a higher likelihood of termination over time. Although not hypothesised, agreeableness was also associated with better physical activity outcomes over time. CONCLUSION: This study provides the largest and the longest evidence of a replicable association between personality and change in physical activity status. Personality may motivate both the initiation and termination of physical activity.

The role of personality traits in inpatient pulmonary rehabilitation response in patients with chronic obstructive pulmonary disease.

BACKGROUND: The effectiveness of pulmonary rehabilitation (PR) is a critical issue for chronic obstructive pulmonary disease (COPD) patients. However, PR response is marked by a strong heterogeneity, partially unexplained to date. We hypothesized that personality traits defined by the Five-Factor Model could modulate the effect of inpatient-PR. OBJECTIVE: The aim was to assess the associations between these five personality traits and PR outcomes. METHODS: 74 persons with COPD admitted for a 5-week inpatient PR program had a personality assessment at the start of the program (T1). Exercise capacity, quality of life, sensory and affective dyspnea dimensions were assessed at T1 and at the end of the program (T2). Their evolution was evaluated using the delta score between T2 and T1. PR response was defined using the minimal clinically important change score for each of them. A composite response was established distinguishing the poor responders' group, made of patients who responded to 0, 1 or 2 parameters and the good responders' group, with patients who responded on 3 or 4 indicators. RESULTS: Logistic regressions analyses highlighted that those with a high level of openness [OR = 0.36, 95% CI = 0.15-0.74, p < 0.01] were less likely to respond on quality of life, controlling for socio-demographic factors and the severity of the disease. CONCLUSION: This study shows that the investigation of the personality constitutes an interesting perspective for better understanding the interindividual differences observed between patients in the PR response. Tailoring clinical intervention to the patient's personality could be a promising prospect for optimizing PR effectiveness.

An examination of potential mediators of the relationship between polygenic scores of BMI and waist circumference and phenotypic adiposity.

Objective: The present study examined whether physical activity, personality, cognition, education, and depressive symptoms mediate the association between polygenic scores (PGS) for body mass index (BMI) and waist circumference and the corresponding phenotypic adiposity measures.Design: Participants were 9,139 individuals aged 50 to 107 years (57% women; Mean Age: 68.17, SD: 10.06) from the Health and Retirement Study who were genotyped. Trained staff measured their height, weight, and waist circumference, and participants answered questions on physical activity, personality, education, cognitive function, and depressive symptoms.Main Outcome Measures: BMI and waist circumference.Results: A higher PGS for both BMI and waist circumference were related to higher phenotypic BMI and waist circumference, respectively, in part through their association with lower physical activity, conscientiousness, education, and higher depressive symptoms but not cognition. The mediators accounted for 6.6% of the association between PGS and BMI and 9.6% of the association between PGS and waist circumference.Conclusion: The present study provides new evidence on the multiple, distinct pathways through which genetic propensity to higher BMI and waist circumference may lead to higher adiposity in adulthood. Individuals with a higher genetic predisposition to obesity may gain more weight through less adaptive behavioral, personality and educational profiles.

Personality and Hearing Acuity: Evidence From the Health and Retirement Study and the English Longitudinal Study of Ageing.

OBJECTIVE: Several determinants of age-related hearing impairment have been identified, but little is known about the predictive value of psychological factors. The present study examined whether five-factor model personality traits are prospectively associated with hearing acuity in middle-aged and older adults. METHODS: Participants were adults aged 50 to 97 years (N > 10,000) drawn from the Health and Retirement Study (2012-2016) and the English Longitudinal Study of Ageing (2010-2014). In each sample, personality, demographic factors, health-related behaviors, body mass index, and memory function were assessed at baseline, and objective hearing acuity was measured 4 years later. RESULTS: In both samples, higher conscientiousness and openness were associated with better hearing acuity and lower risk of impairment, whereas neuroticism was associated with a higher risk of hearing impairment. In the Health and Retirement Study and English Longitudinal Study of Ageing, respectively, 1 standard deviation (1-SD) higher conscientiousness, 1-SD higher openness, and 1-SD lower neuroticism were related to 13% to 10%, 8% to 6%, and 10% to 13% lower likelihoods of hearing impairment, respectively. In both samples, additional analyses revealed that physical activity and memory mediated the association between personality and hearing. CONCLUSIONS: The present study provides robust evidence for an association between personality traits and hearing function. The findings broaden knowledge on risk and mitigating factors for age-related hearing impairment, which has implications for the quality of life of middle-aged and older adults.

Polygenic Score for Alzheimer Disease and cognition: The mediating role of personality.

Alzheimer's disease (AD) polygenic risk score (PGS) is associated with lower cognitive functioning even among older individuals without dementia. We tested the hypothesis that personality traits mediate the association between AD genetic risk and cognitive functioning. Participants (N > 7,000, aged 50-99 years old) from the Health and Retirement Study were genotyped and completed personality and cognition tests at baseline. Cognition was assessed again four years later. Bootstrap analysis revealed that a higher AD polygenic risk score was associated with lower cognitive scores at baseline through higher neuroticism, lower conscientiousness, and lower levels of the industriousness facet of conscientiousness. In addition, a higher polygenic score for AD was associated with decline in cognition over four years in part through higher neuroticism and lower conscientiousness. The findings support the hypothesis that the genetic vulnerability for AD contributes to cognitive functioning in part through its association with personality traits.