0
Original Research: COPD |

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

Carlos H. Martinez, MD, MPH; Alejandro A. Diaz, MD, MPH; Amit D. Parulekar, MD; Stephen I. Rennard, MD; Richard E. Kanner, MD; Nadia N. Hansel, MD, MPH; David Couper, PhD; Kristen E. Holm, PhD; Karin F. Hoth, PhD; Jeffrey L. Curtis, MD; Fernando J. Martinez, MD; Nicola A. Hanania, MD; Elizabeth A. Regan, MD, PhD; Robert Paine, III, MD; Christine T. Cigolle, MD, MPH; MeiLan K. Han, MD
Author and Funding Information

Drs Cigolle and Han contributed equally to this manuscript.

FUNDING/SUPPORT: Dr C. H. Martinez was supported by the National Institutes of Health National Heart, Lung, and Blood Institute [NHLBI; Grant 3R01HL122438-02S1]. Dr Diaz was supported by the NHLBI [Grant K01HL118714] and the Brigham and Women’s Hospital Minority Faculty Career Development Award. Dr Hoth was supported by the NHLBI [Grant K23 HL095658]. Dr Curtis was supported by Clinical Science Research and Development, Department of Veterans Affairs [Merit Review Award I01 CX000911]. Dr Cigolle was supported by the National Institute on Aging [Grant 5K08AG031837] and by the Claude D. Pepper Older Americans Independence Center at the University of Michigan. Dr Han was supported by the NHLBI [Grant R01HL122438-01]. SPIROMICS was funded by the NHLBI [HHSN268200900013C, HHSN268200900014C, HHSN268200900015C, HHSN268200900016C, HHSN268200900017C, HHSN268200900018C, HHSN2682009000019C, and HHSN268200900020C]. COPDGene was supported by the NHLBI [Grants R01HL089897 and R01HL089856].

CORRESPONDENCE TO: Carlos H. Martinez, MD, MPH, Division of Pulmonary and Critical Care Medicine, 3916 Taubman Center, Box 0360, 1500 E. Medical Center Dr, University of Michigan Medical Center, Ann Arbor, MI 48109-0360


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;149(4):927-935. doi:10.1016/j.chest.2015.11.025
Text Size: A A A
Published online

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.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543