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

Carlos H Martinez; Alejandro A Diaz; Amit D Parulekar; Stephen I Rennard; Richard E Kanner; Nadia N Hansel; David Couper; Kristen E Holm; Karin F Hoth; Jeffrey L Curtis; Fernando J Martinez; Nicola A Hanania; Elizabeth A Regan; Robert Paine 3rd; Christine T Cigolle; MeiLan K Han; COPDGene and SPIROMICS Investigators

doi:10.1016/j.chest.2015.11.025

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

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

Authors

Carlos H Martinez¹, Alejandro A Diaz², Amit D Parulekar³, Stephen I Rennard⁴, Richard E Kanner⁵, Nadia N Hansel⁶, David Couper⁷, Kristen E Holm⁸, Karin F Hoth⁹, Jeffrey L Curtis¹⁰, Fernando J Martinez¹¹, Nicola A Hanania³, Elizabeth A Regan¹², Robert Paine 3rd¹³, Christine T Cigolle¹⁴, MeiLan K Han¹¹; COPDGene and SPIROMICS Investigators

Affiliations

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.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Age Factors
Aged
Cohort Studies
Cross-Sectional Studies
Dyspnea / physiopathology*
Female
Health Status*
Humans
Male
Middle Aged
Pulmonary Disease, Chronic Obstructive / physiopathology*
Quality of Life*

Associated data

ClinicalTrials.gov/NCT00608764
ClinicalTrials.gov/NCT01969344

Abstract

Publication types

MeSH terms

Associated data

Grants and funding