Physical Activity Impairment in Depressed COPD Subjects

Abstract

BACKGROUND: Limited exercise tolerance is a cardinal clinical feature in COPD. Depression and COPD share some clinical features, such as reduced physical activity and impaired nutritional status. The aim of the present study was to evaluate maximum and daily physical activities and the nutritional status of COPD patients affected or not by depression. METHODS: In 70 COPD out-patients, daily and maximum physical activities were assessed by multisensor accelerometer armband, 6-min walk test, and cardiopulmonary exercise test. Mental status, metabolic/muscular status, and systemic inflammation were evaluated using the Hospital Anxiety and Depression Scale, by bioelectrical impedance analysis, and with regard to fibrinogen/C-reactive protein, respectively. RESULTS: Depressed subjects (27% of the sample) showed a similar level of respiratory functional impairment but a higher level of shortness of breath and a worse quality of life compared to non-depressed subjects (P < .05). Specifically, they displayed a physical activity impairment consisting of a reduced number of steps per day, a lower peak of oxygen consumption, an early anaerobic threshold, and a reduced distance in the 6-min walk test (P < .05) but the same nutritional status compared to non-depressed subjects. In the multivariate analysis, a reduced breathing reserve, obesity, and a higher level of shortness of breath, but not depression, were found to be independent factors associated with a reduced daily number of steps. CONCLUSIONS: Our study found that depressed COPD patients have a reduced daily and maximum exercise capacity compared to non-depressed patients. This further suggests the potential utility of screening for depression in COPD.

Factors associated with low physical activity in patients with chronic obstructive pulmonary disease: a cross‐sectional study

“…Still after adding the items breathlessness and cough to the subscale or removed lack of energy in additional analyses, this did not change the main result. Depressive symptoms are known to be common among patients with COPD , but depressive symptoms do not seem to be predictive of low PA. One recent study found that depressed patients had lower PA compared to not depressed, but depression was not found to be independently associated with PA . In the present study, there were no differences between patients with low, moderate and high PA with respect to depressive or anxiety symptoms or the symptom burden of psychological symptoms (MSAS‐PSYCH).…”

Physical capacity in performing daily activities is reduced in scleroderma patients with early lung involvement

“…The pivotal importance of reduction in DLco in patients with SSc has been demonstrated by the relationship between decline in DLco and mortality (30). In addition, other variables may influence the non-sedentary or sedentary physical attitudes; they include troubles in nutritional status in both directions of malnutrition and obesity, neither of whom being common or early in the natural history of the disease, or changes of mood, such as depression, which in other respiratory conditions have been demonstrated to play a significant role (31). Finally, PAH deserves a particular interest among mechanisms possibly underlying differences between non-sedentary and sedentary lifestyle.…”

Effect of a postoperative outpatient pulmonary rehabilitation program on physical activity in patients who underwent pulmonary resection for lung cancer

“…Di Marco et al . showed that depressed COPD patients have a reduced daily and maximal exercise capacity compared with non‐depressed patients . Iijima et al .…”