Contribution of the Environment and Comorbidities to Chronic Obstructive Pulmonary Disease Phenotypes

Martínez, Carlos H.; Han, MeiLan K.

doi:10.1016/j.mcna.2012.02.007

Cited by 36 publications

(28 citation statements)

References 106 publications

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“…21 However, lack of impact of acculturation on HR-QOL in other respiratory diseases (eg, sleep disorders) has been reported by Soler et al 29 in a population-based survey comparing sleep quality between Mexican Americans and nonHispanic whites, and we found similar associations. Finally, based on interest in the association of comorbidities with poorer HR-QOL in COPD, 18,30 we also tested this variable as a signifi cant contributor to the ethnic diff erences, with negative results. Th us, aft er extensive analyses, only socioeconomic disparities were major contributors to the ethnic diff erences in HS in OLD.…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic Characteristics Are Major Contributors to Ethnic Differences in Health Status in Obstructive Lung Disease

Martínez

Mannino

Curtis

et al. 2015

Chest

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Section: Discussionmentioning

confidence: 99%

Socioeconomic Characteristics Are Major Contributors to Ethnic Differences in Health Status in Obstructive Lung Disease

Martínez

Mannino

Curtis

et al. 2015

Chest

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“…This finding is on par with the recognition of COPD as a major factor impacting health status at the population level, with associations also stronger than those reported for cardiovascular disease and diabetes (28). The biological plausibility of the COPDdisability association may be related to the idea that there are subgroups of subjects with COPD expressing more severe systemic consequences (29), probably mediated by systemic inflammatory pathways. However, although our findings are aligned with the current view of COPD as a disease with extrapulmonary effects, the elucidation of any mechanism involved is beyond the reach of this study.…”

Section: Discussionmentioning

confidence: 79%

Chronic Obstructive Pulmonary Disease, Cognitive Impairment, and Development of Disability: The Health and Retirement Study

et al. 2014

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Rationale: The relationship between chronic obstructive pulmonary disease (COPD) and cognitive impairment in leading to disability has not been characterized.Objectives: We aimed to investigate the prevalence and cumulative incidence of disability among adults with and without COPD and the association of COPD and cognitive impairment with disability. Methods:We analyzed 2006-2008 waves of the Health and Retirement Study, a nationally representative longitudinal health survey. COPD was self-reported. Prevalent disability was defined as baseline dependency in one or more activities of daily living (ADLs) and incident disability as one or more additional ADL dependencies. We used a validated performance-based measure of cognition to identify dementia and mild cognitive impairment. Covariates included seven chronic diseases, four geriatric syndromes, and sociodemographics. We used logistic regression to test associations between COPD, cognitive status, and prevalent/incident disability.Measurements and Main Results: Of 17,535 participants at least 53 years of age in wave 2006 (representing 77.7 million Americans), 9.5% reported COPD and 13.5% mild cognitive impairment; 17.5% of those with COPD had mild cognitive impairment. Prevalent disability for COPD was 12.8% (5.2% for no-COPD, P , 0.001). An additional 9.2% with COPD developed incident disability at 2 years (4.0% for no-COPD, P , 0.001). In adjusted models, COPD was associated with baseline (odds ratio, 2.0) and incident disability (odds ratio, 2.1; adjusted for baseline disability). Cognitive impairment had an additive effect to COPD. The COPD-disability association, prevalent/incident, was of similar or greater magnitude than that of other chronic diseases (e.g., stroke, diabetes). The associations were maintained in sensitivity analyses using alternative definitions of disability (dependency in two or more ADLs, dependency in instrumental ADLs), and in analysis excluding respondents with dementia.Conclusions: Both COPD and mild cognitive impairment increase the risk of disability. The risk conferred by COPD is significant and similar or higher than other chronic diseases.

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“…When the presence of the disease is part of unique COPD phenotypes. 8 In keeping with these frameworks, we present those comorbidities which fulfill at least one of the characteristics. There is, however, significant heterogeneity in the definitions of each one of these studied diseases and the source of data used to evaluate the associations between it and COPD.…”

Section: Challenges In the Identification And Interpretation Of Copd mentioning

confidence: 99%

“…8 Burgel, et al, used hierarchical cluster analysis of data from more than 500 patients and detected 3 main groups: one with COPD but low burden of comorbidities; a second one with high risk of comorbidities with severe emphysema, low frequency of cardiovascular comorbidities and low BMI. ; and a third with high risk of mortality, mainly due to a high For personal use only.…”

Section: Comorbidity Clusters In Copd Phenotypesmentioning

confidence: 99%

Defining COPD-Related Comorbidities, 2004-2014

2014

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IntroductionOver the past 60 years we have witnessed radical transformations in population demographics and the burden of diseases that are shaping health care and which have an immediate and future impact within the field of respiratory diseases. Despite improvements in life expectancy and lower death rates in the United States over this period, COPD rose to the third leading cause of death in 2008, a testament to the growing importance of chronic diseases and disability.1 Refinements in the understanding of the pathophysiology and mechanisms responsible for susceptibility and heterogeneity of COPD (reviewed in other articles in the same issue of this journal) have occurred over the past 10 years. The search for additional ways to modify important outcomes has been enriched by two separate but related concepts that, at the turn of the century, were not always part of the mainstream AbstractChronic obstructive pulmonary disease (COPD) is a disease of aging in combination with genetic, environmental, and behavioral risk factors. Aging and many of these risk factors are shared with other diseases, and, as a result, it is not surprising that patients with COPD often have coexistent diseases. This review of COPD comorbidities uses a framework in which coexistent diseases are considered important comorbidities if they are more frequent, have more severe consequences, influence the progression and outcomes of COPD, or are clustered together into proposed phenotypes, supplemented by a framework in which certain comorbidities are expected to share specific pathogenic mechanisms. This review explores classic COPD comorbidities such as cardiovascular disease, cachexia and sleep apnea, but also looks at more recently described comorbidities, such as gastroesophageal reflux, osteoporosis and depression/anxiety. understanding of the disease. The first one is that the degree of obstruction -which defines the disease and its severity -does not fully correlate with COPD outcomes (exacerbations, death, and health-related quality-of-life [HR-QOL]). 2,3 The second is that a bidirectional interplay exists between the persistent inflammatory processes damaging the lungs and other organs. As a result, COPD is a complex disease linked with other comorbidities that influences treatment effectiveness and outcomes. This paper presents a review of the importance of COPD comorbidities in the development, progression, prognosis and therapy of COPD, and identifies the gaps in knowledge and research in this area. Challenges in the Identification and Interpretation of COPD ComorbiditiesIn the United States, COPD patients are usually older adults who have a history of tobacco exposure. These traits are shared with other chronic conditions, including cardiovascular disease and cancer. The typical patient with COPD reports, on average, 4 or more additional diseases 4 and on any given day one-third of COPD patients use 5-10 different medications. 5 There are several different frameworks that can help to decide if the relevance of a coexistent dise...

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Contribution of the Environment and Comorbidities to Chronic Obstructive Pulmonary Disease Phenotypes

Cited by 36 publications

References 106 publications

Socioeconomic Characteristics Are Major Contributors to Ethnic Differences in Health Status in Obstructive Lung Disease

Socioeconomic Characteristics Are Major Contributors to Ethnic Differences in Health Status in Obstructive Lung Disease

Chronic Obstructive Pulmonary Disease, Cognitive Impairment, and Development of Disability: The Health and Retirement Study

Defining COPD-Related Comorbidities, 2004-2014

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