Abstract
BackgroundOptimism is the general belief that good things will occur in the future; optimism is modifiable by cognitive behavioral therapy (CBT). Previous studies have associated higher optimism with improved health outcomes and lower all-cause mortality.Research questionInvestigate association between optimism and disease-related characteristics in chronic obstructive pulmonary disease (COPD).Study design and methodsCurrent and former smokers with/without COPD and Preserved Ratio Impaired Spirometry (PRISm) from the 10-year follow-up visit for the Genetic Epidemiology of COPD (COPDGene) study were included. Optimism was assessed at the 10-year visit using the Life Orientation Test-Revised. Models of optimism as a predictor of lung function, COPD-associated phenotypes including exacerbations, and functional assessments, were adjusted for demographic confounders, smoking status, and comorbidities.ResultsAmong 1967 subjects, higher optimism was significantly associated with older age, non-Hispanic white race, marital status, quitting smoking status, absence of COPD, and absence of depression. In multivariable analysis, higher optimism was independently associated with fewer prior exacerbations of COPD (coef = − 0.037, P < 0.001). Higher optimism was also related to better MMRC scores (coef = − 0.041, P < 0.001), CAT scores (coef = − 0.391, P < 0.001), SGRQ scores (coef = − 0.958, P < 0.001), BODE index (coef = − 0.059, P < 0.001), and longer 6-min walk distance (coef = 10.227, P < 0.001). After stratification by severity of COPD, these associations with optimism were still significant in all groups. No significant association was observed for cross-sectional FEV1 (%) or FVC (%) with optimism score.InterpretationFewer exacerbations and less severe respiratory symptoms and higher functional capacity were associated with higher optimism, which may impact health outcomes in current and former smokers with and without COPD. Optimism is a modifiable trait and these results may further support a role for CBT to improve outcomes in COPD.
Highlights
Optimism is a personality trait characterized by the positive expectation that good things will happen in the future [1]
Significant associations between higher optimism score with fewer respiratory symptoms and better MMRC, chronic obstructive pulmonary disease (COPD) Assessment Test (CAT), Saint George’s Respiratory Questionnaire (SGRQ) score, 6-min walk distance, and BODE index were present in univariable analysis (Table 2 and Figs. 1, 2)
For the prior severe exacerbation events, in model 1 adjusted for demographics and health behavior (DM + health behavior factors (HB)), these associations remained significant, but in model 2, after further adjustment for other health conditions (DM + HB + HC), the association was attenuated but the effect was in the same direction
Summary
Optimism is a personality trait characterized by the positive expectation that good things will happen in the future [1]. Empirical studies have described that individuals with higher optimism are more likely to be successful [2–6]. Positive associations between optimism and favorable physical health outcomes, especially related to cardiovascular events and all-cause mortality, were reported in a recent meta-analysis [9]. In the Nurses’ Health Study, all-cause and cause-specific mortality rates were followed prospectively after measuring optimism scores, and women with higher optimism had lower all-cause and cause-specific mortality related to respiratory disease, cancer, heart disease, stroke, and infection [10]. Previous studies have associated higher optimism with improved health outcomes and lower all-cause mortality. Research question: Investigate association between optimism and disease-related characteristics in chronic obstructive pulmonary disease (COPD)
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