Quality of Life in Older Patients With Chronic Obstructive Pulmonary Disease (COPD) in Hong Kong: A Case-Control Study

Authors

  • Yu-Tao Xiang MD, PhD,

    Research Assistant Professor
    1. Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
    2. Faculty of Health Sciences, University of Macau, Macao SAR, China
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    • The authors equally contributed to this work.
  • Tak-Shun Wong MRCPsy,

    Associate Consultant Psychiatrist
    1. Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
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    • The authors equally contributed to this work.
  • Joshua Tsoh FRCPsy,

    Consultant Psychiatrist
    1. Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
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    • The authors equally contributed to this work.
  • Gabor S. Ungvari MD, PhD,

    Professor
    1. School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Western Australia, Australia
    2. The University of Notre Dame Australia/Marian Centre, Perth, Western Australia, Australia
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  • Christoph U. Correll MD,

    Professor
    1. Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, New York, USA
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  • Jitender Sareen MD,

    Professor
    1. Department of Psychiatry, University of Manitoba Faculty of Medicine, Winnipeg, Canada
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  • Kirsten Penner-Goeke MD,

    a Medical Student
    1. Department of Psychiatry, University of Manitoba Faculty of Medicine, Winnipeg, Canada
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  • Fanny W.S. Ko MD, FHKAM(Med),

    Associate Consultant
    1. Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China
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  • David S.C. Hui FRCP, FCCP,

    Professor
    1. Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China
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  • Helen F.K. Chiu FRCPsy

    Professor, Corresponding author
    1. Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
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  • Conflict of Interest Statement
  • Dr. Correll has been a consultant and/or advisor to or has received honoraria from: Actelion, Alexza; American Academy of Child and Adolescent Psychiatry, Bristol-Myers Squibb, Cephalon, Eli Lilly, Genentech, Gerson Lehrman Group, IntraCellular Therapies, Lundbeck, Medavante, Medscape, Merck, National Institute of Mental Health, Janssen/J&J, Otsuka, Pfizer, ProPhase, Roche, Sunovion, Takeda, Teva, and Vanda. He has received grant support from BMS, Feinstein Institute for Medical Research, Janssen/J&J, National Institute of Mental Health (NIMH), National Alliance for Research in Schizophrenia and Depression (NARSAD), and Otsuka. He has been a Data Safety Monitoring Board member for Cephalon, Eli Lilly, Janssen, Lundbeck, Pfizer, Takeda, and Teva. The remaining authors had no conflicts of interest in conducting this study or preparing the manuscript.

Abstract

Purpose

To date, there have been few studies examining quality of life (QOL) in older patients with chronic obstructive pulmonary disease (COPD) in China. The aim of the study was to assess QOL in Chinese older patients with COPD and explore its demographic and clinical correlates.

Design and Methods

Case-control study of 142 outpatients with COPD and 218 matched control subjects without COPD. COPD patients were recruited from a prospective study sample hospitalized in Hong Kong for acute COPD exacerbation (≥ 2 major COPD symptoms or > 1 major + minor COPD symptoms for ≥ 2 consecutive days). Controls were recruited from social centers in Hong Kong. Activity of daily living was assessed with the Instrumental Activities of Daily Living Scale (IADL), life events were evaluated with the Life Event Scale, depressive disorders were diagnosed using the Geriatric Depression Scale (GDS), and QOL was measured using the Medical Outcomes Study Short Form-12 (SF-12) and St. George's Respiratory Questionnaire (SGRQ).

Findings

Compared to controls, patients had significantly lower scores in the physical (PCS score), but not in the mental (MCS score) QOL domain. Multivariate analyses showed that more hospitalizations in the past year significantly contributed to higher PCS score (p = .03), while higher GDS total score contributed to lower MCS score (p = .003). Severe and very severe COPD, more physical illnesses, and higher IADL total score each independently contributed to higher SGRQ total score, explaining 40.0% of the variance (p < .001).

Practice Implications

Our results suggest that therapeutic and psychosocial interventions alleviating depressive symptoms, severe COPD, comorbidities, and improving IADL in Chinese patients with COPD are likely of considerable benefit for improving QOL in patients with COPD.

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