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Observational Study
. 2018 Mar 6:13:823-831.
doi: 10.2147/COPD.S154791. eCollection 2018.

Depressive status explains a significant amount of the variance in COPD assessment test (CAT) scores

Marc Miravitlles  1 , Jesús Molina  2 , José Antonio Quintano  3 , Anna Campuzano  4 , Joselín Pérez  4 , Carlos Roncero  5 ; DEPREPOC study investigators
Affiliations
Observational Study

Depressive status explains a significant amount of the variance in COPD assessment test (CAT) scores

Marc Miravitlles et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Background: COPD assessment test (CAT) is a short, easy-to-complete health status tool that has been incorporated into the multidimensional assessment of COPD in order to guide therapy; therefore, it is important to understand the factors determining CAT scores.

Methods: This is a post hoc analysis of a cross-sectional, observational study conducted in respiratory medicine departments and primary care centers in Spain with the aim of identifying the factors determining CAT scores, focusing particularly on the cognitive status measured by the Mini-Mental State Examination (MMSE) and levels of depression measured by the short Beck Depression Inventory (BDI).

Results: A total of 684 COPD patients were analyzed; 84.1% were men, the mean age of patients was 68.7 years, and the mean forced expiratory volume in 1 second (%) was 55.1%. Mean CAT score was 21.8. CAT scores correlated with the MMSE score (Pearson's coefficient r=-0.371) and the BDI (r=0.620), both p<0.001. In the multivariate analysis, the usual COPD severity variables (age, dyspnea, lung function, and comorbidity) together with MMSE and BDI scores were significantly associated with CAT scores and explained 45% of the variability. However, a model including only MMSE and BDI scores explained up to 40% and BDI alone explained 38% of the CAT variance.

Conclusion: CAT scores are associated with clinical variables of severity of COPD. However, cognitive status and, in particular, the level of depression explain a larger percentage of the variance in the CAT scores than the usual COPD clinical severity variables.

Keywords: BDI; Beck Depression Inventory; CAT; COPD; MMSE; Mini-Mental State Examination.

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Conflict of interest statement

Disclosure Marc Miravitlles has received speaker fees from Boehringer Ingelheim, AstraZeneca, Chiesi, GlaxoSmithKline, Menarini, Teva, Grifols, and Novartis and consulting fees from Boehringer Ingelheim, GlaxoSmithKline, Gebro Pharma, CLS Behring, Cipla, MediImmune, Mereo Biopharma, Teva, Novartis, and Grifols. Carlos Roncero has received fees to give talks for Janssen-Cilag, Bristol-Myers Squibb, Ferrer-Brainfarma, Pfizer, Reckitt Benckiser, Lundbeck, Otsuka, Servier, Lilly, GSK, Rovi, and Adamed. He has received financial compensation for his participation as a member of the Janssen-Cilag, Lilly, and Shire boards and conducted the PROTEUS project, which was funded by a grant from Reckitt-Benckisert. Anna Campuzano and Joselín Pérez are full-time employees of Grupo Ferrer (Barcelona, Spain). José Antonio Quintano has received speaker fees from Almirall, Bayer, Boehringuer, Ferrer, GSK, Novartis, Menarini, and TEVA; consulting fees from Almirall, Boehringuer, Ferrer, Menarini, Novartis, Mundipharma; and registration support for medical congresses from Almirall, Pfizer, Gebro, GSK, Mundipharma, Novartis, and ROVI. Jesús Molina has received speaker fees from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Novartis, Mundifarma, and Pfizer and consulting fees from Boehringer Ingelheim, Gebro Pharma, Mundifarma, and GlaxoSmithKline. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Distribution of CAT scores among participants. Abbreviation: CAT, COPD assessment test.
Figure 2
Figure 2
Correlation between CAT score and MMSE scores (A), BDI scores (B), post-bronchodilator FEV1 (% predicted) (C), and post-bronchodilator FEV1/FVC (D). Abbreviations: BDI, Beck Depression Inventory; CAT, COPD assessment test; FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity; MMSE, Mini-Mental State Examination.
See this image and copyright information in PMC

References

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