Chronic obstructive pulmonary disease (COPD) in elderly subjects: impact on functional status and quality of life

Peruzza, Silvia; Sergi, Giuseppe; Vianello, Andrea; Pisent, Claudia; Tiozzo, Francesca; Manzan, Alessandro; Coin, Alessandra; Inelmen, Eminè Meral; Enzi, Giuliano

doi:10.1053/rmed.2003.1488

Cited by 154 publications

(126 citation statements)

References 20 publications

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“…Exercise intolerance is one of the important aspects of health related quality of life in COPD (19,20) and there is considerable evidences that pulmonary rehabilitation programs improve exercise tolerance and patients' health related quality of life (21,22). There is little evidence about the relationship between subjective complaints in COPD and objective parameters.…”

Section: Discussionmentioning

confidence: 99%

Correlation of cardiopulmonary exercise testing parameters with quality of life in stable COPD patients

Mirdamadi¹,

Rahimi²,

Safavi³

et al. 2016

J. Thorac. Dis.

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Background: The precise head to head relationships between Cardio-pulmonary exercise testing (CPET) parameters and patients' daily symptoms/activities and the disease social/emotional impact are less well defined. In this study, the correlation of COPD daily symptoms and quality of life [assessed by St. George's Respiratory Questionnaire (SGRQ)] and COPD severity index (BODE-index) with CPET parameters were investigated. Methods: Symptom-limited CPET was performed in 37 consecutive COPD (GOLD I-III) subjects during non-exacerbation phase. The SGRQ was also completed by each patient. Results: SGRQ-score correlated negatively with FEV1 (r=−0.49, P<0.01), predicted maximal workrate (%WR-max) (r=−0.44, P<0.01), V'O 2 /WR (r=−0.52, P<0.01) and breathing reserve (r=−0.50, P<0.01). However it did not correlate with Peak-V'O 2 % predicted (r=−0.27, P=0.10). In 20 (54.1%) subjects in which leg fatigue was the main cause for stopping the test, Peak-V'O 2 , %WR-max, HR-Reserve and Breathing reserve were higher (P=0.04, <0.01, 0.04 and <0.01 respectively) than the others. There was also a significant correlation between BODE-index and ∆VO 2 /∆WR (r=−0.64, P<0.001) and breathing-reserve (r=−0.38, P=0.018). Conclusions: The observed relationships between CPET parameter and daily subjective complaints in COPD were not strong. Those who discontinued the CPET because of leg fatigue were in the earlier stages of COPD. Significant negative correlation between ∆VO 2 /∆WR and BODE-index suggests that along with COPD progression, regardless of negative past history, other comorbidities such as cardiac/musculoskeletal problems should be sought. Although more difficult to use than other tools such as COPD Assessment Test (CAT) or COPD Clinical Questionnaire (CCQ) during routine daily practice (6), the St. George's Respiratory Questionnaire (SGRQ) is one of the most widely used self-complete measures in research for assessing patients' symptoms, activities and quality of life (7,8). Along with this subjective measurement, functional capacity in COPD could be measured by objective tools such as cardio-pulmonary exercise testing (CPET) or 6-min walk distance (6MWD) (9-11). Considering the fact that at rest physiologic variable such as pulmonary diffusing capacity for carbon monoxide (DLCO), body mass index (BMI) or even forced expiratory volume in one second (FEV1) could not solely predict exercise intolerance, CPET has been proposed as the gold standard for evaluating the exercise intolerance in patients with pulmonary diseases, including COPD (12). But the precise head to head comparisons of CPET variable with patients' daily symptoms/activities and the disease social/ emotional impact are less well defined. In one study among 129 COPD subjects with GOLD stage II and III, there was at best a weak correlation between Peak-V'O 2 (maximum oxygen uptake) % predicted and some sub-domains of health status (13). While in another study Peak-V'O 2 was to some extent a predictor of physical function (r 2 increased by 0.109) and health-related ...

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Section: Discussionmentioning

confidence: 99%

Correlation of cardiopulmonary exercise testing parameters with quality of life in stable COPD patients

Mirdamadi¹,

Rahimi²,

Safavi³

et al. 2016

J. Thorac. Dis.

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“…This population-based approach, has provided robust answers to most of the questions which stimulated initiation of this project [1][2][3][4][5][7][8][9][10].…”

Section: Discussionmentioning

confidence: 99%

The prognostic influence of chronic obstructive pulmonary disease in patients hospitalised for chronic heart failure

Macchia¹,

Monte

Romero

et al. 2007

European J of Heart Fail

101

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Aims: To investigate the prevalence and the prognostic impact of chronic obstructive pulmonary disease (COPD), in patients hospitalised with chronic heart failure (CHF). Methods and results:In an observational study based on longitudinal information from administrative registers, 1020 patients aged ≥ 60 years, who were chronically treated for and hospitalised with CHF were identified and followed-up for major events up to 1 year.Median age was 80 years, half of the patients were female and 241 patients (23.6%) had concomitant COPD. There were no differences in the prevalence of cardiovascular and non-cardiovascular comorbidities between CHF patients with or without COPD. However, COPD patients were more often male (60.6% vs. 46.3%), more frequently treated with diuretics (95.9% vs. 91.5%) but less often exposed to β-blockers (16.2% vs. 22.0%). Significantly higher adjusted in-hospital (HR 1.50 [95%CI 1.00-2.26]) and out-of-hospital (1.42 [1.09-1.86]) mortality rates were found in CHF patients with concomitant COPD. A higher occurrence of non-fatal AMI/stroke/rehospitalisation for CHF (1.26 [1.01-1.58]) as well as hospitalisation for CHF (1.35 [1.00-1.82]) was associated with COPD. Conclusions: COPD is a frequent concomitant disease in patients with heart failure and it is an independent short-term prognostic indicator of mortality and cardiovascular comorbidity in patients who have been admitted to hospital for heart failure.

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“…[14][15] Studies report on the severe physical symptoms patients experience (mostly breathlessness), 6,8,9,16 and also on psychological and social symptoms, such as anxiety, 6,9,16 depression, 6,9,16 and social isolation. 8,17 Jones et al 5 also reported that many patients would not express needs even when prompted.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

The silence of patients with end-stage COPD: a qualitative study

et al. 2008

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Patients with end-stage chronic obstructive pulmonary disease (COPD) experience poor quality of life and considerable problems in daily life. However, as they often do not actively express a wish for help, they do not get the help they need. AimTo gain insight into why patients with end-stage COPD tend not to express a wish for help. Design of studyProspective qualitative study with semi-structured interviews. SettingOutpatient clinics of four hospitals and one centre specialising in asthma and COPD in the Netherlands. MethodSixteen semi-structured interviews were conducted with 11 patients with end-stage COPD.

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Chronic obstructive pulmonary disease (COPD) in elderly subjects: impact on functional status and quality of life

Cited by 154 publications

References 20 publications

Correlation of cardiopulmonary exercise testing parameters with quality of life in stable COPD patients

Correlation of cardiopulmonary exercise testing parameters with quality of life in stable COPD patients

The prognostic influence of chronic obstructive pulmonary disease in patients hospitalised for chronic heart failure

The silence of patients with end-stage COPD: a qualitative study

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