Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 27 (1), 36

Physical Activity and Risk of Comorbidities in Patients With Chronic Obstructive Pulmonary Disease: A Cohort Study

Affiliations

Physical Activity and Risk of Comorbidities in Patients With Chronic Obstructive Pulmonary Disease: A Cohort Study

Tsung Yu et al. NPJ Prim Care Respir Med.

Abstract

Multi-morbidity is common in patients with chronic obstructive pulmonary disease and low levels of physical activity are hypothesized to be an important risk factor. The current study aimed to assess the longitudinal association between physical activity and risk of seven categories of comorbidity in chronic obstructive pulmonary disease patients. The study included 409 patients from primary care practice in the Netherlands and Switzerland. We assessed physical activity using the Longitudinal Ageing Study Amsterdam Physical Activity Questionnaire at baseline and followed patients for up to 5 years. During follow-up, patients reported their comorbidities (cardiovascular, neurological, endocrine, musculoskeletal, malignant, and infectious diseases) and completed the Hospital Anxiety and Depression Scale questionnaire for mental health assessment. We implemented multinomial logistic regression (an approximation to discrete time survival model using death as a competing risk) for our analysis. Study results did not suggest a statistically significant association of baseline physical activity with the development of seven categories of comorbidity. However, when we focused on depression and anxiety symptoms, we found that higher levels of physical activity at baseline were associated with a lower risk for depression (adjusted hazard ratio, 0.85; 0.75-0.95; p = 0.005) and anxiety (adjusted hazard ratio, 0.89; 0.79-1.00; p = 0.045). In chronic obstructive pulmonary disease patients, those with high physical activity are less likely to develop depression or anxiety symptoms over time. Increasing physical activity in chronic obstructive pulmonary disease patients may be an approach for testing to lower the burden from incident depression and anxiety.

Chronic lung disease: STAY ACTIVE TO AVOID DEPRESSION AND ANXIETY: Patients with chronic lung disease who stay physically active could reduce their chances of depression and anxiety. Milo Puhan at the University of Zurich, Switzerland, and co-workers assessed the association between physical activity and the risk of developing various co-existing diseases in 409 patients with chronic obstructive pulmonary disease (COPD). Co-morbidities such as cardiovascular diseases, diabetes and depression are prevalent in patients with COPD, but the reasons why are not clear. Puhan's team assessed patients' activity levels using an existing questionnaire, and administered another questionnaire to assess mental health. They followed the cohort for 5 years. Results indicated weak associations between physical activity levels and most physical illnesses, but there were significant links between higher levels of physical activity and a reduced risk of depression and anxiety. The results could inform novel COPD treatment programs.

Conflict of interest statement

The authors declare that they have no competing financial interests.

Figures

Fig. 1
Fig. 1
Distribution of patients with 0 or 1 category of comorbidities, ≥2 categories of comorbidities, and patients who were dead or lost to follow-up over time (n = 409). Seven categories of comorbidities were included. At each visit, we recorded if the patients had been diagnosed with cardiovascular diseases, neurological disorders, endocrine disorders, musculoskeletal disorders, and cancers and we also recorded if the patients had ever reported having infections and mental disorders (anxiety or depression) after being enrolled in the study. Over time, patients in the groups “0 or 1 comorbidity” or “≥2 comorbidities” can move to the group “death” or “loss to follow-up”. Also, patients in the group “0 or 1 comorbidity” can move to the group “≥2 comorbidities”
Fig. 2
Fig. 2
Associations of physical activity with incident comorbidities. The relative-risk ratios estimated from multinomial logistic regression models (competing risk model) were interpreted as hazard ratios. Age, sex, body mass index, smoking pack-years, and forced expiratory volume in 1 s (liters) were included as covariates in the model

Similar articles

See all similar articles

Cited by 3 PubMed Central articles

References

    1. Burrows B, et al. The emphysematous and bronchial types of chronic airways obstruction. A clinicopathological study of patients in London and Chicago. Lancet. 1966;1:830–835. doi: 10.1016/S0140-6736(66)90181-4. - DOI - PubMed
    1. Vanfleteren LE, et al. Clusters of comorbidities based on validated objective measurements and systemic inflammation in patients with chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care. Med. 2013;187:728–735. doi: 10.1164/rccm.201209-1665OC. - DOI - PubMed
    1. Decramer M, Janssens W. Chronic obstructive pulmonary disease and comorbidities. Lancet Respir. Med. 2013;1:73–83. doi: 10.1016/S2213-2600(12)70060-7. - DOI - PubMed
    1. Burgel PR, et al. Impact of comorbidities on COPD-specific health-related quality of life. Respir. Med. 2013;107:233–241. doi: 10.1016/j.rmed.2012.10.002. - DOI - PubMed
    1. Divo M, et al. Comorbidities and risk of mortality in patients with chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 2012;186:155–161. doi: 10.1164/rccm.201201-0034OC. - DOI - PubMed
Feedback