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

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

Carlos H Martinez  1 , Alejandro A Diaz  2 , Amit D Parulekar  3 , Stephen I Rennard  4 , Richard E Kanner  5 , Nadia N Hansel  6 , David Couper  7 , Kristen E Holm  8 , Karin F Hoth  9 , Jeffrey L Curtis  10 , Fernando J Martinez  11 , Nicola A Hanania  3 , Elizabeth A Regan  12 , Robert Paine 3rd  13 , Christine T Cigolle  14 , MeiLan K Han  11 ; COPDGene and SPIROMICS Investigators
Affiliations

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

Carlos H Martinez et al. Chest. 2016 Apr.

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.

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Figures

Figure 1
Figure 1
SGRQ total score by age group in each cohort. All differences between middle-aged and older adult groups, in each cohort, are significant at P < .05. The box represents the interquartile range and the central line the median. COPDGene = Genetic Epidemiology of COPD; SGRQ = St. George’s Respiratory Questionnaire; SPIROMICS = Subpopulations and Intermediate Outcome Measures in COPD Study.
Figure 2
Figure 2
Average effect of different degrees of dyspnea on SGRQ total score by age group among participants in the Genetic Epidemiology of COPD study. mMRC = modified Medical Research Council. See Figure 1 legend for expansion of other abbreviation.
Figure 3
Figure 3
Average effect of different degrees of dyspnea on SGRQ total score by age group among participants in the Subpopulations and Intermediate Outcome Measures in COPD Study. See Figure 1 and 2 legends for expansion of abbreviations.
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