Depression in elderly outpatients with disabling chronic obstructive pulmonary disease

Age Ageing. 1998 Mar;27(2):155-60. doi: 10.1093/ageing/27.2.155.

Abstract

Introduction: Depression is common in both young adults and elderly people with chronic obstructive pulmonary disease (COPD).

Methods: We compared the prevalence of depressive symptomatology in elderly outpatients with stable disabling COPD with that in healthy controls and age-matched patients with other disabilities, and also assessed the relation between degree of disability, quality of life and depressive symptoms. The subjects were 96 older people with COPD [56 men; aged 70-93 (mean 78) years], 55 normal controls [23 men; aged 70-90 (mean 78) years] and 53 disabled controls [27 men; aged 70-92 (mean 78) years]. Exclusion criteria were acute respiratory exacerbation or use of oral steroids in the last 6 weeks, known previous psychiatric disorder and acute or chronic confusion.

Results: Mean (and SD) values for 1-s forced expiratory volume (FEV1) were 51 (20) % in COPD subjects, 107 (24) % in normal controls and 82 (13)% in disabled controls. Forty-four subjects with COPD (46%), six normal controls (11%) and 14 disabled controls (26%) scored in the 'caseness' range for depressive ideation on the Brief Assessment Schedule Depression Cards (BASDEC) screening questionnaire. A multiple regression analysis was performed for the COPD group to identify factors predictive of BASDEC score. Predictive variables were total quality of life score [P<0.0001], Chronic Respiratory Questionnaire and level of activities of daily living (Nottingham extended activities of daily living scale) [P = 0.001]. Spirometry results and exercise tolerance (6-min walk distance) did not help predict BASDEC score (R2 = 0.50).

Conclusions: Depressive symptoms are common in elderly patients with COPD; prevalence and/or severity of depressive symptoms may be greater in those who are most disabled.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Depression / epidemiology*
  • Disability Evaluation
  • Dyspnea / epidemiology
  • Dyspnea / psychology
  • Female
  • Forced Expiratory Volume
  • Humans
  • Male
  • Outpatients / psychology*
  • Outpatients / statistics & numerical data*
  • Prevalence
  • Pulmonary Disease, Chronic Obstructive / epidemiology*
  • Pulmonary Disease, Chronic Obstructive / psychology*
  • Quality of Life
  • Regression Analysis
  • Severity of Illness Index
  • Spirometry