The association between co-morbidities and physical performance in people with chronic obstructive pulmonary disease

Li, Lok Sze Katrina; Caughey, Gillian E.; Johnston, Kylie

doi:10.1177/1479972313516879

Cited by 10 publications

(3 citation statements)

References 48 publications

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“…However, no association was found between the GOLD score and emphysema grade in the group with two or more comorbidities. As COPD causes major morbidity as shown by many authors,38 such an association was not unexpected. In fact, it may support the hypothesis that the GOLD score is a measure of morbidity.…”

Section: Discussionmentioning

confidence: 71%

The effect of comorbidities on COPD assessment: a pilot study

Weinreich

Thomsen

Bielaska

et al. 2015

COPD

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IntroductionPatients with chronic obstructive pulmonary disease (COPD) frequently suffer from comorbidities. COPD severity may be evaluated by the Global initiative for chronic Obstructive Lung Disease (GOLD) combined risk assessment score (GOLD score). Spirometry, body plethysmography, diffusing capacity of the lung for carbon monoxide (DLCO), and high-resolution computed tomography (HR-CT) measure lung function and elucidate pulmonary pathology. This study assesses associations between GOLD score and measurements of lung function in COPD patients with and without (≤1) comorbidities. It evaluates whether the presence of comorbidities influences evaluation by GOLD score of COPD severity, and questions whether GOLD score describes morbidity rather than COPD severity.MethodsIn this prospective study, 106 patients with stable COPD were included. Patients treated for lung cancer were excluded. Demographics, oxygen saturation (SpO2), modified Medical Research Council Dyspnea Scale, COPD exacerbations, and comorbidities were recorded. Body plethysmography and DLCO were measured, and HR-CT performed and evaluated for emphysema and airways disease. COPD severity was stratified by the GOLD score. Correlation analyses: 1) GOLD score, 2) emphysema grade, and 3) airways disease and lung function parameters, described by: forced expiratory volume in the first second in percent of expected value (FEV1%), inspiratory capacity (IC%), total lung volume (TLC%), IC/TLC, and SpO2. Correlation analyses between subgroups and hierarchical cluster analysis were performed.ResultsSignificant associations were found between GOLD score and both emphysema grade (correlation coefficients [cc]: −0.2, P=0.03) and lung function parameters (cc: −0.5 to −0.7, P-values all <0.001) weakened in patients with >1 comorbidity (cc: −0.4 to −0.5, P-values all 0.001). Significant differences between subgroups were found in GOLD score and both FEV1% (cc: −0.2, P=0.02) and IC/TLC (cc: −0.2, P=0.02). Comorbidities were associated with GOLD score and composite measures in hierarchical cluster analysis.ConclusionThe presence of comorbidities influences the relationship between GOLD score and lung function measurements. GOLD score may be more representative of morbidity than of COPD severity.

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Section: Discussionmentioning

confidence: 71%

The effect of comorbidities on COPD assessment: a pilot study

Weinreich

Thomsen

Bielaska

et al. 2015

COPD

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“…Although there was a dose-response association between sport/exercise and mortality risk, sport is not feasible for most people with COPD due to the older age of the population and the high prevalence of comorbidities such as poly-pharmacy and mobility problems [ 21 ], which are associated with poorer physical performance [ 22 ]. Walking, however, is an achievable and accessible type of PA.…”

Section: Discussionmentioning

confidence: 99%

Associations of total and type-specific physical activity with mortality in chronic obstructive pulmonary disease: a population-based cohort study

et al. 2018

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BackgroundRegular physical activity is recommended for all people with chronic obstructive pulmonary disease (COPD), but the dose of physical activity required to gain mortality benefit in this population is not yet known. This aim of this study was to examine the associations of total and type-specific physical activity with mortality risk in people with COPD.MethodsPeople with COPD aged ≥40 years were identified from the 1997 Health Survey for England and the 1998 and 2003 Scottish Health Survey cohorts. Self-reported total physical activity, moderate-vigorous intensity physical activity (MVPA), walking, domestic physical activity, and sport/exercise were assessed at baseline. Cox proportional hazards models were used to examine the associations between physical activity and mortality risk.ResultsTwo thousand three hundred ninety-eight participants with COPD were included in the analysis and followed up for a mean 8.5 (SD 3.9) years. For both total physical activity and MVPA, we observed dose-response associations with all-cause and cardiovascular disease (CVD) mortality risk, and with respiratory mortality risk to a lesser extent. Compared to those who reported no physical activity, participants who met the physical activity guidelines demonstrated the greatest reductions in all-cause (HR 0.56, 95% CI 0.45–0.69), CVD (HR 0.48, 95% CI 0.32–0.71) and respiratory mortality risk (HR 0.40, 95% CI 0.24–0.67). Participants who reported a level of physical activity of at least half the dosage recommended by the guidelines also had a reduced risk of all-cause (HR 0.75, 95% CI 0.56–1.00) and CVD mortality (HR 0.48, 95% CI 0.26–0.88). Dose-response associations with mortality risk were demonstrated for walking and sport/exercise, but not domestic physical activity.ConclusionsWe found a dose-response association between physical activity and all-cause and CVD mortality risk in people with COPD, with protective effects appearing at levels considerably lower than the general physical activity recommendations. People with COPD may benefit from engagement in low levels of physical activity, particularly walking and structured exercise.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-5167-5) contains supplementary material, which is available to authorized users.

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“…Depressive symptoms are associated with mortality 6,7 , disease exacerbation, dyspnea 8 , decreased physical performance, inactivity 9 and functional limitations in activities of daily living (ADL) [10][11][12][13] . Functional limitation is experienced through progressive loss of physical conditioning, with decreased ability to carry out ADL and reduced muscle strength due to systemic manifestations of disease which may become more severe if associated with depressive symptoms [14][15][16] .…”

Section: Introductionmentioning

confidence: 99%

Activities of daily living in patients with chronic obstructive pulmonary disease with depressive symptoms

et al. 2020

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This cross-sectional study assessed the activities of daily living (ADL) and risk factors for developing depressive symptoms in patients with chronic obstructive pulmonary disease (COPD) and was carried out at the pulmonology outpatient clinic of the Hospital Universitário Oswaldo Cruz. Two hundred two (202) patients with COPD participated in the study. We evaluated the sociodemographic and anthropometric data, the ADL by means of Pulmonary Functional Status and Dyspnea Questionnaire - Modified version (PFSDQ-M), and the presence of depressive symptoms using the Beck Depression Inventory (BDI). All domains (dyspnea, fatigue and activity changes) of PFSDQ are compromised in patients with depressive symptoms. The prevalence of depressive symptoms was 38.6%. The chance of developing these symptoms was higher for those who used more than one bronchodilator (OR: 2.82, CI 95%: 1.47-5.38, p=0.002), presented dyslipidemias (OR: 2.74, CI95%: 1.24-6.07, p=0.012), had a heart disease (OR: 2.82, CI 95%: 1.18-6.74, p=0.020), presented expectoration (OR: 2.44, CI 95%: 1.2-4.95, p=0.014) or did not have a partner (OR: 2.58, CI 95%: 1.36-4.9, p=0.004). COPD patients with depressive symptoms had all domains of ADL compromised compared to patients without these symptoms.

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The association between co-morbidities and physical performance in people with chronic obstructive pulmonary disease

Cited by 10 publications

References 48 publications

The effect of comorbidities on COPD assessment: a pilot study

The effect of comorbidities on COPD assessment: a pilot study

Associations of total and type-specific physical activity with mortality in chronic obstructive pulmonary disease: a population-based cohort study

Activities of daily living in patients with chronic obstructive pulmonary disease with depressive symptoms

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