TY - JOUR
T1 - Comparative Impact of Depressive Symptoms and FEV1% on Chronic Obstructive Pulmonary Disease
AU - SPIROMICS investigators
AU - O'Toole, Jacqueline
AU - Woo, Han
AU - Putcha, Nirupama
AU - Cooper, Christopher B.
AU - Woodruff, Prescott
AU - Kanner, Richard E.
AU - Paine, Robert
AU - Bowler, Russell P.
AU - Comellas, Alejandro
AU - Hoth, Karin F.
AU - Krishnan, Jerry A.
AU - Han, Meilan
AU - Dransfield, Mark
AU - Iyer, Anand S.
AU - Couper, David
AU - Peters, Stephen P.
AU - Criner, Gerard
AU - Kim, Victor
AU - Barr, R. Graham
AU - Martinez, Fernando J.
AU - Hansel, Nadia N.
AU - Eakin, Michelle N.
N1 - Funding Information:
Supported by grants from the National Heart, Lung, and Blood Institute (National Institutes of Health [NIH] R01 HL128620-02, NIH F32 HL143864-01, NIH 5 T32 HL 7534-35, NIH K23HL123594), and the National Institute of Environmental Health Sciences (R01ES023500).
Publisher Copyright:
Copyright © 2022 by the American Thoracic Society.
PY - 2022/2
Y1 - 2022/2
N2 - Rationale: Individuals with chronic obstructive pulmonary disease (COPD) have a high prevalence of depression, which is associated with increased COPD hospitalizations and readmissions. Objectives: Examine the impact of depressive symptoms compared with FEV1% on COPD morbidity. Methods: Using longitudinal data from individuals with COPD in the Subpopulations and Intermediate Outcome Measures in COPD Study, longitudinal growth analysis was performed to assess COPD morbidity by assessing differences in baseline 6-minute walk distance and patient reported outcomes (PROs) and their rate of change over time explained by depressive symptoms or lung function, as measured by Hospital Anxiety and Depression Scale or FEV1% respectively. PROs consisted of in-person completion of St. George's Respiratory Questionnaire, COPD Assessment Test, Functional Assessment of Chronic Illness Therapy Fatigue, and Modified Medical Research Council Dyspnea Scale measures. Results: Of the individuals analyzed (n = 1,830), 43% were female, 81% Caucasian with mean ± SD age of 65.1 ± 8.1, and 52.7 ± 27.5 pack-years smoking. Mean ± SD FEV1% was 60.9 ± 23.0% and 20% had clinically significant depressive symptoms. Adjusted models showed higher Hospital Anxiety and Depression Scale scores and lower FEV1% each were associated with worse PROs at baseline (P ≤ 0.001). Depression accounted for more baseline variance in St. George's Respiratory Questionnaire, COPD Assessment Test, and Functional Assessment of Chronic Illness Therapy Fatigue than FEV1%, explaining 30-67% of heterogeneity. FEV1% accounted for more baseline variance in Modified Medical Research Council Dyspnea Scale and 6-minute walk distance than depression, explaining 16-32% of heterogeneity. Depressive symptoms accounted for 3-17% variance in change over time in PROs. In contrast, FEV1% accounted for 1-4% variance over time in PROs. Conclusions: Depression is more strongly associated with many PROs at baseline and their change over time compared with FEV1%. Recognizing and incorporating the impact of depressive symptoms into individualized care may improve COPD outcomes.
AB - Rationale: Individuals with chronic obstructive pulmonary disease (COPD) have a high prevalence of depression, which is associated with increased COPD hospitalizations and readmissions. Objectives: Examine the impact of depressive symptoms compared with FEV1% on COPD morbidity. Methods: Using longitudinal data from individuals with COPD in the Subpopulations and Intermediate Outcome Measures in COPD Study, longitudinal growth analysis was performed to assess COPD morbidity by assessing differences in baseline 6-minute walk distance and patient reported outcomes (PROs) and their rate of change over time explained by depressive symptoms or lung function, as measured by Hospital Anxiety and Depression Scale or FEV1% respectively. PROs consisted of in-person completion of St. George's Respiratory Questionnaire, COPD Assessment Test, Functional Assessment of Chronic Illness Therapy Fatigue, and Modified Medical Research Council Dyspnea Scale measures. Results: Of the individuals analyzed (n = 1,830), 43% were female, 81% Caucasian with mean ± SD age of 65.1 ± 8.1, and 52.7 ± 27.5 pack-years smoking. Mean ± SD FEV1% was 60.9 ± 23.0% and 20% had clinically significant depressive symptoms. Adjusted models showed higher Hospital Anxiety and Depression Scale scores and lower FEV1% each were associated with worse PROs at baseline (P ≤ 0.001). Depression accounted for more baseline variance in St. George's Respiratory Questionnaire, COPD Assessment Test, and Functional Assessment of Chronic Illness Therapy Fatigue than FEV1%, explaining 30-67% of heterogeneity. FEV1% accounted for more baseline variance in Modified Medical Research Council Dyspnea Scale and 6-minute walk distance than depression, explaining 16-32% of heterogeneity. Depressive symptoms accounted for 3-17% variance in change over time in PROs. In contrast, FEV1% accounted for 1-4% variance over time in PROs. Conclusions: Depression is more strongly associated with many PROs at baseline and their change over time compared with FEV1%. Recognizing and incorporating the impact of depressive symptoms into individualized care may improve COPD outcomes.
KW - COPD
KW - Depression
KW - Patient reported outcome measures
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UR - http://www.scopus.com/inward/citedby.url?scp=85123968696&partnerID=8YFLogxK
U2 - 10.1513/AnnalsATS.202009-1187OC
DO - 10.1513/AnnalsATS.202009-1187OC
M3 - Article
C2 - 34410883
AN - SCOPUS:85123968696
SN - 2325-6621
VL - 19
SP - 171
EP - 178
JO - Annals of the American Thoracic Society
JF - Annals of the American Thoracic Society
IS - 2
ER -