The impact of age on prevalence of anxiety, depression and stress in patients with chronic obstructive pulmonary disease

Abstract

Background: Over 40 % of patients with chronic obstructive pulmonary disease (COPD) suffer from mood and anxiety disorders. However, little is known about the impact of age on the prevalence of anxiety, depression and stress in patients with COPD. We examined the prevalence of depression, anxiety and stress in patients with COPD aged 65 years and older compared to less than 65 years old and their relation to quality of life (QoL), dyspnea, lung function and exercise capacity.

Methods: From our research database, we examined 993 clinically stable COPD patients recruited from 2013 to 2019, before entering pulmonary rehabilitation (PR). At baseline, COPD patients completed: dyspnea measured by modified Medical Research Council (mMRC) scale, exercise capacity by incremental shuttle walk test (ISWT), QoL by St. George's Respiratory Questionnaire (SGRQ), and psychological distress by Depression Anxiety Stress Scale (DASS).

Results: Seven-hundred-sixty-seven patients with COPD ≥65 years with mean age (SD) 75 (6) years were compared to 226 patients with COPD <65 years with mean age 58 (6) years. Patients <65 years compared to patients ≥65 years with COPD had higher scores for DASS-depression ≥10, (61 % vs. 38 %), DASS-anxiety ≥8 (73 % vs 51 %) and DASS-stress ≥15 (45 % vs. 25 %) all (p < 0.001). Younger patients with COPD had poorer QoL, elevated dyspnea, and lower FEV₁ percentage predicted, (all p < 0.001). No significant difference in exercise capacity was seen between the two groups (p = 0.58).

Conclusion: Younger COPD patients exhibited higher levels of depression, anxiety and stress, with poorer QoL and elevated symptoms of dyspnea compared to older patients.

Keywords: COPD depression anxiety stress quality of life dyspnoea.