Depressive status explains a significant amount of the variance in COPD assessment test (CAT) scores
Received 22 October 2017
Accepted for publication 16 January 2018
Published 6 March 2018 Volume 2018:13 Pages 823—831
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
Marc Miravitlles,1 Jesús Molina,2 José Antonio Quintano,3 Anna Campuzano,4 Joselín Pérez,4 Carlos Roncero5
On behalf of the DEPREPOC study investigators
1Department of Pneumology, Hospital Universitari Vall d’Hebron, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain; 2Centro de Salud Francia, Dirección Asistencial Oeste, Madrid, Spain; 3Centro de Salud Lucena I, Lucena, Cordoba, Spain; 4Medical Department Grupo Ferrer, Barcelona, Spain; 5Psychiatric Service, University of Salamanca Health Care Complex, Institute of Biomedicine of Salamanca, University of Salamanca, Salamanca, Spain
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: COPD, CAT, Mini-Mental State Examination, MMSE, Beck Depression Inventory, BDI
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