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

Frontiers in Medicine

article

Leah J. Witt¹  Kristen E. Wroblewski²  Jayant M. Pinto³  Esther Wang⁴  Martha K. McClintock⁵  William Dale⁶  Steven R. White⁷  Valerie G. Press⁷  Megan Huisingh-Scheetz⁷ 

[1] Department of Medicine, University of California;Department of Public Health Sciences, The University of Chicago;Department of Surgery, The University of Chicago Medicine;Pritzker School of Medicine, The University of Chicago;Department of Comparative Human Development, The Institute for Mind and Biology, University of Chicago;Department of Supportive Care Medicine;Department of Medicine, The University of Chicago

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

DOI  :  10.3389/fmed.2022.814606

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Rationale Chronic obstructive pulmonary disease (COPD) predominantly affects older adults. However, the co-morbid occurrence of geriatric conditions has been understudied. Objective Characterize the prevalence of geriatric conditions among community-dwelling U.S. older adults with self-reported COPD. Methods We 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 Results Self-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. Conclusions Geriatric 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】

CC BY