Disability in valued life activities among individuals with COPD and other respiratory conditions

Abstract

Purpose: The purpose of this study was to delineate the effect of chronic obstructive pulmonary disease (COPD) on a broad range of valued life activities (VLAs) and make comparisons to effects of other airways conditions.

Methods: We used cross-sectional data from a population-based, longitudinal study of US adults with airways disease. Data were collected by telephone interview. VLA disability was compared among 3 groups defined by reported physician diagnoses: COPD/emphysema, chronic bronchitis, and asthma. Multiple regression analyses were conducted to identify independent predictors of VLA disability.

Results: About half of individuals with COPD were unable to perform at least 1 VLA; almost all reported at least 1 VLA affected. The impact among individuals with chronic bronchitis and asthma was less but still notable: 74%-84% reported at least 1 activity affected, and about 15% were unable to perform at least 1 activity. In general, obligatory activities were the least affected. Symptom measures and functional limitations were the strongest predictors of disability, independent of respiratory condition.

Conclusion: VLA disability is common among individuals with COPD. Obligatory activities are less affected than committed and discretionary activities. A focus on obligatory activities, as is common in disability studies, would miss a great deal of the impact of these conditions. Because individuals are often referred to pulmonary rehabilitation as a result of dissatisfaction with ability to perform daily activities, VLA disability may be an especially relevant outcome for rehabilitation.

Figure 1. Recruitment and retention of airways disease cohort

Recruitment and retention of airways disease cohort through Wave 5 (2006; data used for current study).

Figure 2. Proportion of each condition group with at least one VLA affected and proportion unable to perform at least one VLA

Proportion of the COPD, chronic bronchitis, and asthma groups who reported at least one VLA affected by their condition, and proportion of each group who reported being unable to perform at least one VLA because of their condition. Except for “Unable, Obligatory,” all differences between groups are statistically significant (p<.0001) by χ² analysis.