Depression symptoms reduce physical activity in COPD patients: a prospective multicenter study
Received 28 November 2015
Accepted for publication 25 January 2016
Published 10 June 2016 Volume 2016:11(1) Pages 1287—1295
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Charles Downs
Peer reviewer comments 3
Editor who approved publication: Dr Richard Russell
Iván Dueñas-Espín,1–5 Heleen Demeyer,6 Elena Gimeno-Santos,1–3 Michael I Polkey,7 Nicholas S Hopkinson,7 Roberto A Rabinovich,8 Fabienne Dobbels,9 Niklas Karlsson,10 Thierry Troosters,6,11 Judith Garcia-Aymerich1–3
On behalf of the PROactive Consortium
1ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), 2Universitat Pompeu Fabra (UPF), 3CIBEREpidemiología y Salud Pública (CIBERESP), Barcelona, Spain; 4Secretaría Nacional de Educación Superior, Ciencia, Tecnología e Innovación del Ecuador (SENESCYT), Quito, Ecuador; 5Institut d’investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; 6Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium; 7NIHR Respiratory Biomedical Research Unit at the Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London, UK; 8ELEGI Colt Laboratory, Centre for Inflammation Research, The Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK; 9Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium; 10Health Economics and Outcomes Research, AstraZeneca R&D, Mölndal, Sweden; 11Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium
Background: The role of anxiety and depression in the physical activity (PA) of patients with COPD is controversial. We prospectively assessed the effect of symptoms of anxiety and depression on PA in COPD patients.
Methods: We evaluated anxiety and depression (Hospital Anxiety and Depression Scale [HADS]), PA (Dynaport® accelerometer), and other relevant characteristics in 220 COPD patients from five European countries at baseline and at 6 and 12 months of follow-up. HADS score was categorized as: no symptoms (score 0–7), suggested (8–10), and probable (>11) anxiety or depression. We estimated the association between anxiety and depression at t (baseline and 6 months) and PA at t+1 (6 and 12 months) using regression models with a repeated measures approach.
Results: Patients had a mean (standard deviation) age of 67 (8) years, forced expiratory volume in 1 second 57 (20)% predicted. At baseline, the prevalence of probable anxiety and depression was 10% and 5%, respectively. In multivariable models adjusted by confounders and previous PA, patients performed 81 fewer steps/day (95% confidence interval, -149 to -12, P=0.02) per extra point in HADS-depression score. HADS-anxiety symptoms were not associated with PA.
Conclusion: In COPD patients, symptoms of depression are prospectively associated with a measurable reduction in PA 6 months later.
Keywords: COPD, anxiety, depression, HADS, physical activity, prospective study
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