Beyond the Lung: Geriatric Conditions Afflict Community-Dwelling Older Adults With Self-Reported Chronic Obstructive Pulmonary Disease

Frontiers in Medicine

Martha K. McClintock¹  Megan Huisingh-Scheetz²  Steven R. White²  Valerie G. Press²  Leah J. Witt³  Kristen E. Wroblewski⁴  William Dale⁵  Jayant M. Pinto⁶  Esther Wang⁷ 

[1] Department of Comparative Human Development, The Institute for Mind and Biology, University of Chicago, Chicago, IL, United States;Department of Medicine, The University of Chicago, Chicago, IL, United States;Department of Medicine, University of California, San Francisco, San Francisco, CA, United States;Department of Public Health Sciences, The University of Chicago, Chicago, IL, United States;Department of Supportive Care Medicine, City of Hope, Duarte, CA, United States;Department of Surgery, The University of Chicago Medicine, Chicago, IL, United States;Pritzker School of Medicine, The University of Chicago, Chicago, IL, United States;

关键词: geriatrics;    functional impairment;    COPD–chronic obstructive pulmonary disease;    polypharmacy (source: MeSH;    frailty);    loneliness;   

DOI  :  10.3389/fmed.2022.814606

来源: DOAJ

【 摘 要 】

RationaleChronic obstructive pulmonary disease (COPD) predominantly affects older adults. However, the co-morbid occurrence of geriatric conditions has been understudied.ObjectiveCharacterize the prevalence of geriatric conditions among community-dwelling U.S. older adults with self-reported COPD.MethodsWe conducted a nationally representative, cross-sectional study of 3,005 U.S. community-dwelling older adults (ages 57–85 years) from the National Social Life, Health, and Aging Project (NSHAP). We evaluated the prevalence of select geriatric conditions (multimorbidity, functional disability, impaired physical function, low physical activity, modified frailty assessment, falls, polypharmacy, and urinary incontinence) and psychosocial measures (frequency of socializing, sexual activity in the last year, loneliness, cognitive impairment, and depressive symptoms) among individuals with self-reported COPD as compared to those without. Using multivariate logistic and linear regressions, we investigated the relationships between COPD and these geriatric physical and psychosocial conditions.Main ResultsSelf-reported COPD prevalence was 10.7%, similar to previous epidemiological studies. Individuals with COPD had more multimorbidity [modified Charlson score 2.6 (SD 1.9) vs. 1.6 (SD 1.6)], more functional disability (58.1 vs. 29.6%; adjusted OR 3.1, 95% CI 2.3, 4.3), falls in the last year (28.4 vs. 20.8%; adjusted OR 1.4, 95% CI 1.01, 2.0), impaired physical function (75.8 vs. 56.6%; adjusted OR 2.1, 95% CI 1.1, 3.7), more frequently reported extreme low physical activity (18.7 vs. 8.1%; adjusted OR 2.3, 95% CI 1.5, 3.5) and higher frailty prevalence (16.0 vs. 2.7%; adjusted OR 6.3, 95% CI 3.0,13.0) than those without COPD. They experienced more severe polypharmacy (≥10 medications, 37.5 vs. 16.1%; adjusted OR 2.9, 95% CI 2.0, 4.2). They more frequently reported extreme social disengagement and were lonelier, but the association with social measures was eliminated when relationship status was accounted for, as those with COPD were less frequently partnered. They more frequently endorsed depressive symptoms (32.0 vs. 18.9%, adjusted OR 1.9, 95% CI 1.4, 2.7). There was no noted difference in cognitive impairment between the two populations.ConclusionsGeriatric conditions are common among community-dwelling older adults with self-reported COPD. A “beyond the lung” approach to COPD care should center on active management of geriatric conditions, potentially leading to improved COPD management, and quality of life.

【 授权许可】

Unknown