The potential profiles of dyspnea catastrophizing and the relationship between emotion-social loneliness in elderly patients with chronic obstructive pulmonary disease

Objective To explore the latent profile classification of dyspnea catastrophizing in elderly patients with chronic obstructive pulmonary disease (COPD) and its relationship with emotional-social loneliness. Methods A total of 287 elderly patients with COPD were prospectively and consecutively recruited from five respiratory wards of the Respiratory Center at the Sixth People's Hospital of Nantong between October 2024 and April 2025. This cross-sectional study assessed dyspnea catastrophizing cognition and emotional-social loneliness using the Breathlessness Catastrophizing Scale and the emotional-social loneliness inventory. Latent profile analysis was conducted to identify potential categories of catastrophizing. Multivariate analysis of variance and generalized linear model (GLM) were used to examine the differences in emotional-social loneliness among different types of patients and the robustness of the grouping effect. Results The categorization of dyspnea catastrophization can be divided into three distinct profiles: C1, the “Catastrophic-Fixation Group” (18.1%), C2, the “Vigilant-Fear Group” (50.9%), and C3, the “Adaptive-Management Group” (31.0%). These three groups of patients exhibited graded differences across each dimension of emotional-social loneliness, with C1 and > C2 >showing greater differences than C3 ( P < 0.001). Notably, the dimension with the greatest difference was social isolation (Δ = 10.0 points). After controlling for confounding variables using the GLM, the catastrophizing subtype still independently accounted for 21%–26% of the variance in loneliness (η² p = 0.21–0.26, P < 0.001). Conclusion There is significant variability in the catastrophizing cognition of dyspnea among elderly patients with COPD. The three latent profiles are progressively associated with emotional-social loneliness, offering a targeted foundation for precise psychological interventions.