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Chest. 2016 Apr;149(4):927-35. doi: 10.1016/j.chest.2015.11.025. Epub 2015 Dec 17.

Age-Related Differences in Health-Related Quality of Life in COPD: An Analysis of the COPDGene and SPIROMICS Cohorts.

Author information

1
Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI. Electronic address: carlosma@umich.edu.
2
Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
3
Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, TX.
4
Division of Pulmonary and Critical Care Medicine, University of Nebraska, Omaha, NE.
5
University of Utah, Salt Lake City, UT.
6
Johns Hopkins University, Baltimore, MD.
7
University of North Carolina at Chapel Hill, Chapel Hill, NC.
8
National Jewish Health, Denver, CO; School of Public Health, University of Colorado, Aurora, CO.
9
Department of Psychiatry, University of Iowa, Iowa City, IA.
10
Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI; VA Ann Arbor Healthcare System, Ann Arbor, MI.
11
Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI.
12
National Jewish Health, Denver, CO; University of Colorado, Denver, CO.
13
University of Utah, Salt Lake City, UT; VA Salt Lake City, Salt Lake City, UT.
14
Department of Family Medicine, University of Michigan, Ann Arbor, MI; VA Ann Arbor Healthcare System, Ann Arbor, MI.

Abstract

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 COPDGene 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 (β, 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.

TRIAL REGISTRY:

ClinicalTrials.gov; No.: NCT00608764 and No.: NCT01969344; URL: www.clinicaltrials.gov.

KEYWORDS:

COPD; aging; dyspnea; geriatrics; health status; obstructive lung disease; quality of life

PMID:
26836895
PMCID:
PMC4944781
DOI:
10.1016/j.chest.2015.11.025
[Indexed for MEDLINE]
Free PMC Article

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