Respiratory symptoms in adults are related to impaired quality of life, regardless of asthma and COPD: results from the European community respiratory health survey

Health and Quality of Life Outcomes

Research

Valerie Siroux¹  Isabelle Pin¹  Estel Plana²  Josep M Antó³  Benedicte Leynaert⁴  Cecilie Svanes⁵  Ernst R Omenaas⁶  Marianne Voll-Aanerud⁷  Tomas ML Eagan⁸  Per S Bakke⁸ 

[1] CHU de Grenoble, INSERM U823, Université Joseph Fourier-Grenoble, Grenoble, France;Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain;Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain;Municipal Institute of Medical Research (IMIM-Hospital del Mar), CIBER Epidemiologia y Salud Pública (CIBERESP); and Universitat Pomeu Fabra, Barcelona, Spain;Institut National de la Santé et de la Recherche Médicale, Unit 700, Epidemiologie, Paris, France;Institute of Medicine, University of Bergen, Bergen, Norway;Institute of Medicine, University of Bergen, Bergen, Norway;Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway;Institute of Medicine, University of Bergen, Bergen, Norway;Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain;Institute of Medicine, University of Bergen, Bergen, Norway;Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway;

关键词: Asthma;    Chronic Obstructive Pulmonary Disease;    Respiratory Symptom;    Physical Component Summary;    Mental Component Summary;   

DOI  :  10.1186/1477-7525-8-107

 received in 2010-01-12, accepted in 2010-09-27,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundRespiratory symptoms are common in the general population, and their presence is related to Health-related quality of life (HRQoL). The objective was to describe the association of respiratory symptoms with HRQoL in subjects with and without asthma or COPD and to investigate the role of atopy, bronchial hyperresponsiveness (BHR), and lung function in HRQoL.MethodsThe European Community Respiratory Health Survey (ECRHS) I and II provided data on HRQoL, lung function, respiratory symptoms, asthma, atopy, and BHR from 6009 subjects. Generic HRQoL was assessed through the physical component summary (PCS) score and the mental component summary (MCS) score of the SF-36.Factor analyses and linear regressions adjusted for age, gender, smoking, occupation, BMI, comorbidity, and study centre were conducted.ResultsHaving breathlessness at rest in ECRHS II was associated with mean score (95% CI) impairment in PCS of -8.05 (-11.18, -4.93). Impairment in MCS score in subjects waking up with chest tightness was -4.02 (-5.51, -2.52). The magnitude of HRQoL impairment associated with respiratory symptoms was similar for subjects with and without asthma/COPD. Adjustments for atopy, BHR, and lung function did not explain the association of respiratory symptoms and HRQoL in subjects without asthma and/or COPD.ConclusionSubjects with respiratory symptoms had poorer HRQoL; including subjects without a diagnosis of asthma or COPD. These findings suggest that respiratory symptoms in the absence of a medical diagnosis of asthma or COPD are by no means trivial, and that clarifying the nature and natural history of respiratory symptoms is a relevant challenge.Several community studies have estimated the prevalence of common respiratory symptoms like cough, dyspnoea, and wheeze in adults [1–3]. Although the prevalence varies to a large degree between studies and geographical areas, respiratory symptoms are quite common. The prevalences of respiratory symptoms in the European Community Respiratory Health Study (ECRHS) varied from one percent to 35% [1]. In fact, two studies have reported that more than half of the adult population suffers from one or more respiratory symptoms [4, 5].Respiratory symptoms are important markers of the risk of having or developing disease. Respiratory symptoms have been shown to be predictors for lung function decline [6–8], asthma [9, 10], and even all-cause mortality in a general population study [11]. In patients with a known diagnosis of asthma or chronic obstructive pulmonary disease (COPD), respiratory symptoms are important determinants of reduced health related quality of life (HRQoL) [12–15]. The prevalence of respiratory symptoms exceeds the combined prevalences of asthma and COPD, and both asthma and COPD are frequently undiagnosed diseases [16–18]. Thus, the high prevalence of respipratory symptoms may mirror undiagnosed and untreated disease.The common occurrence of respiratory symptoms calls for attention to how these symptoms affect health also in subjects with no diagnosis of obstructive airways disease. Impaired HRQoL in the presence of respiratory symptoms have been found in two population-based studies [6, 19], but no study of respiratory sypmtoms and HRQoL have separate analyses for subjects with and without asthma and COPD, and no study provide information about extensive objective measurements of respiratory health.The ECRHS is a randomly sampled, multi-cultural, population based cohort study. The ECRHS included measurements of atopy, bronchial hyperresponsiveness (BHR), and lung function, and offers a unique opportunity to investigate how respiratory symptoms affect HRQoL among subjects both with and without obstructive lung disease.In the present paper we aimed to: 1) Describe the relationship between respiratory symptoms and HRQoL in an international adult general population and: 2) To assess whether this relationship varied with presence of asthma and/or COPD, or presence of objective functional markers like atopy and BHR.

【 授权许可】

CC BY   
© Voll-Aanerud et al; licensee BioMed Central Ltd. 2010