TY - JOUR
T1 - Age-related differences in health-related quality of life in COPD
T2 - An analysis of the COPDGene and SPIROMICS Cohorts
AU - the COPDGene and SPIROMICS Investigators
AU - Martinez, Carlos H.
AU - Diaz, Alejandro A.
AU - Parulekar, Amit D.
AU - Rennard, Stephen I.
AU - Kanner, Richard E.
AU - Hansel, Nadia N.
AU - Couper, David
AU - Holm, Kristen E.
AU - Hoth, Karin F.
AU - Curtis, Jeffrey L.
AU - Martinez, Fernando J.
AU - Hanania, Nicola A.
AU - Regan, Elizabeth A.
AU - Paine, Robert
AU - Cigolle, Christine T.
AU - Han, Meilan K.
N1 - Funding Information:
FUNDING/SUPPORT: Dr C. H. Martinez was supported by the National Institutes of Health National Heart, Lung, and Blood Institute [NHLBI; Grant 3R01HL122438-02S1]. Dr Diaz was supported by the NHLBI [Grant K01HL118714] and the Brigham and Women’s Hospital Minority Faculty Career Development Award. Dr Hoth was supported by the NHLBI [Grant K23 HL095658]. Dr Curtis was supported by Clinical Science Research and Development, Department of Veterans Affairs [Merit Review Award I01 CX000911]. Dr Cigolle was supported by the National Institute on Aging [Grant 5K08AG031837] and by the Claude D. Pepper Older Americans Independence Center at the University of Michigan. Dr Han was supported by the NHLBI [Grant R01HL122438-01]. SPIROMICS was funded by the NHLBI [HHSN268200900013C, HHSN268200900014C, HHSN268200900015C, HHSN268200900016C, HHSN268200900017C, HHSN268200900018C, HHSN2682009000019C, and HHSN268200900020C]. COPDGene was supported by the NHLBI [Grants R01HL089897 and R01HL089856].
Funding Information:
Financial/nonfinancial disclosures: The authors have reported to CHEST the following: S. I. R. has served as a consultant, participated in advisory boards, and received an honorarium for speaking or grant support from American Board of Internal Medicine, Advantage Healthcare, Almirall, American Thoracic Society, AstraZeneca, Baxter, Boehringer Ingelheim, Chiesi, ClearView Healthcare, Cleveland Clinic, Complete Medical Group, CSL, Daiichi Sankyo, Decision Resources Group, Forest, Gerson Lehrman Group, Grifols, groupH, Guidepoint Global, Haymarket, Huron Consulting Group, inThought, Johnson and Johnson, Methodist Health System Dallas, NCI Consulting, Novartis, Pearl, Penn Technology, Pfizer, PlanningShop, PSL FirstWord, Qessential Medical Market Research, Takeda, Theron, and WebMD. J. L. C. has received grant funding from MedImmune. F. J. M. has served as a consultant, participated in advisory boards, and received an honorarium for speaking or grant support from Nycomed/Takeda, Amgen, Boehringer Ingelheim, Genentech, GlaxoSmithKline, Ikaria, Janssen, Johnson and Johnson, Roche, Veracyte, Bayer, Forest, Gilead Sciences, Promedior, and Novartis. N.A.H. has participated as a member of advisory boards or as a consultant for Boehringer Ingelheim, GlaxoSmithKline, Sunovion, Mylan, AstraZeneca, and Novartis and has received research funding (to her institution) from GlaxoSmithKline, Boehringer Ingelheim, Mylan, Sunovian, Chiesi, Genentech, Novartis, and Pfizer. M. K. H. participated in advisory boards for Boehringer Ingelheim and GlaxoSmithKline; participated in speaker’s bureaus for Boehringer Ingelheim, GlaxoSmithKline, Grifols, and Forest; has consulted for United BioSource Corporation; and has received royalties from UpToDate. None declared (C. H. M., A. A. D., A. D. P., R. E. K., N. N. H., D. C., K. E. H., K. F. H., E. A. R., R. P., and C. T. C.).
Publisher Copyright:
Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
PY - 2016/4
Y1 - 2016/4
N2 - OBJECTIVE: Younger persons with COPD report worse health-related quality of life (HRQL) than do older individuals. The factors explaining these differences remain unclear. The objective of this article was to explore factors associated with age-related differences in HRQL in COPD. METHODS: Cross-sectional analysis of participants with COPD, any Global Initiative for Chronic Obstructive Lung Disease grade of airflow limitation, and ≥ 50 years old in two cohorts: the Genetic Epidemiology of COPD (COPDGene) study and the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS). We compared St. George's Respiratory Questionnaire (SGRQ) scores by age group: middle-aged (age, 50-64) vs older (age, 65-80) adults. We used multivariate linear modeling to test associations of age with HRQL, adjusting for demographic and clinical characteristics and comorbidities. RESULTS: Among 4,097 participants in the COPD Gene study (2,170 middle-aged and 1,927 older adults) SGRQ total scores were higher (worse) among middle-aged (mean difference, -4.2 points; 95% CI, -5.7 to -2.6; P < .001) than older adults. Age had a statistically significant interaction with dyspnea (P < .001). Greater dyspnea severity (modified Medical Research Council ≥ 2, compared with 0-1) had a stronger association with SGRQ score among middle-aged (β, 24.6; 95% CI, 23.2-25.9) than older-adult (b, 21.0; 95% CI, 19.6-22.3) participants. In analyses using SGRQ as outcome in 1,522 participants in SPIROMICS (598 middle-aged and 924 older adults), we found similar associations, confirming that for the same severity of dyspnea there is a stronger association with HRQL among younger individuals. CONCLUSIONS: Age-related differences in HRQL may be explained by a higher impact of dyspnea among younger subjects with COPD.
AB - OBJECTIVE: Younger persons with COPD report worse health-related quality of life (HRQL) than do older individuals. The factors explaining these differences remain unclear. The objective of this article was to explore factors associated with age-related differences in HRQL in COPD. METHODS: Cross-sectional analysis of participants with COPD, any Global Initiative for Chronic Obstructive Lung Disease grade of airflow limitation, and ≥ 50 years old in two cohorts: the Genetic Epidemiology of COPD (COPDGene) study and the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS). We compared St. George's Respiratory Questionnaire (SGRQ) scores by age group: middle-aged (age, 50-64) vs older (age, 65-80) adults. We used multivariate linear modeling to test associations of age with HRQL, adjusting for demographic and clinical characteristics and comorbidities. RESULTS: Among 4,097 participants in the COPD Gene study (2,170 middle-aged and 1,927 older adults) SGRQ total scores were higher (worse) among middle-aged (mean difference, -4.2 points; 95% CI, -5.7 to -2.6; P < .001) than older adults. Age had a statistically significant interaction with dyspnea (P < .001). Greater dyspnea severity (modified Medical Research Council ≥ 2, compared with 0-1) had a stronger association with SGRQ score among middle-aged (β, 24.6; 95% CI, 23.2-25.9) than older-adult (b, 21.0; 95% CI, 19.6-22.3) participants. In analyses using SGRQ as outcome in 1,522 participants in SPIROMICS (598 middle-aged and 924 older adults), we found similar associations, confirming that for the same severity of dyspnea there is a stronger association with HRQL among younger individuals. CONCLUSIONS: Age-related differences in HRQL may be explained by a higher impact of dyspnea among younger subjects with COPD.
KW - Aging
KW - COPD
KW - Dyspnea
KW - Geriatrics
KW - Health status
KW - Obstructive lung disease
KW - Quality of life
UR - http://www.scopus.com/inward/record.url?scp=84964526832&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84964526832&partnerID=8YFLogxK
U2 - 10.1016/j.chest.2015.11.025
DO - 10.1016/j.chest.2015.11.025
M3 - Article
C2 - 26836895
AN - SCOPUS:84964526832
SN - 0012-3692
VL - 149
SP - 927
EP - 935
JO - Diseases of the chest
JF - Diseases of the chest
IS - 4
ER -