PURPOSE: BACKGROUND: COPD patients are physically inactive and this predicts poor outcome. However, activity levels vary widely among patients, and factors influencing it are poorly understood. Depression is common in COPD and may be one variable affecting activity. Accordingly, we evaluated the relationship between depressive symptoms and activity in patients with COPD.
METHODS: METHODS: Outpatients with COPD were recruited. Inclusion criteria included an FEV1/FVC < 0.70, an FEV1 < 80%, no exacerbation within 4 weeks, and absence of any significant mobility disorder. An additional inclusion criterion was the Hospital Anxiety and Depression Scale (HADS) depression score, which was required to be ≤ 7 or ≥ 10 (low and high levels of depressive symptoms. respectively). Sixteen patients with high depression scores (DEPR) and 20 with low depression scores (non-DEPR), were studied. Physical activity was measured over 7 consecutive days using the SenseWear™ Armband (BodyMedia, Inc.) worn on the arm. Other variables measured included HADS anxiety and the 6 minute walk distance (6MWD).
RESULTS: RESULTS: The mean age was 69 ± 9 years and the FEV1 was 49 ± 16%. The HADS depression scores in DEPR and Non-DEPR were 12.0 ± 2.3 and 3.7 ± 2.0, respectively. There were no significant between-group differences in age, gender, BMI, FEV1, supplemental oxygen requirement and 6MWD. DEPR patients had higher HADS anxiety scores than non-DEPR patients: 7.4 ± 4.8 vs 4.3 ± 3.3, p < 0.0001). DEPR and non-DEPR patients did not differ in estimated steps per day (3490 ± 2020 vs 3634 ± 2000, p = 0.83) or estimated percent of time per day with activity > 3 METS (9 ± 7 vs 12 ± 8, p - 0.31). Additionally, HADS anxiety level was not related to activity. Steps correlated with the FEV1 (r = 0.49, p = 0.002) and the 6MWD (r = 0.69, p = 0.0001).
CONCLUSIONS: CONCLUSION: We were unable to demonstrate a relationship between depressive symptoms and directly-measured physical activity level in patients with clinically-stable COPD.
CLINICAL IMPLICATIONS: Our study indicates that treatment of depression will not have a significant improvement in physical activity levels in patients with COPD.
DISCLOSURE: The following authors have nothing to disclose: Venkata Narasimhadevara, Jose Angelo De Dios, Richard ZuWallack, Bimalin Lahiri
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