Abstract
Multi-morbidity is common in patients with chronic obstructive pulmonary disease and low levels of physical activity are hypothesized to be an important risk factor. The current study aimed to assess the longitudinal association between physical activity and risk of seven categories of comorbidity in chronic obstructive pulmonary disease patients. The study included 409 patients from primary care practice in the Netherlands and Switzerland. We assessed physical activity using the Longitudinal Ageing Study Amsterdam Physical Activity Questionnaire at baseline and followed patients for up to 5 years. During follow-up, patients reported their comorbidities (cardiovascular, neurological, endocrine, musculoskeletal, malignant, and infectious diseases) and completed the Hospital Anxiety and Depression Scale questionnaire for mental health assessment. We implemented multinomial logistic regression (an approximation to discrete time survival model using death as a competing risk) for our analysis. Study results did not suggest a statistically significant association of baseline physical activity with the development of seven categories of comorbidity. However, when we focused on depression and anxiety symptoms, we found that higher levels of physical activity at baseline were associated with a lower risk for depression (adjusted hazard ratio, 0.85; 0.75–0.95; p = 0.005) and anxiety (adjusted hazard ratio, 0.89; 0.79–1.00; p = 0.045). In chronic obstructive pulmonary disease patients, those with high physical activity are less likely to develop depression or anxiety symptoms over time. Increasing physical activity in chronic obstructive pulmonary disease patients may be an approach for testing to lower the burden from incident depression and anxiety.
Highlights
The clinical manifestations of chronic obstructive pulmonary disease (COPD) are diverse
The aim of the current study was to assess the longitudinal association of physical activity (PA) with the incidence of comorbidities. We studied this in a 5-year prospective follow-up study of COPD patients including seven categories of comorbidity, that is, cardiovascular, neurological, endocrine, musculoskeletal, mental, malignant, and infectious diseases
The median of the Longitudinal Ageing Study Amsterdam Physical Activity Questionnaire (LAPAQ) score that is indicative of types of PA and weighted by intensity was 11
Summary
The clinical manifestations of chronic obstructive pulmonary disease (COPD) are diverse. The “pink puffer” and the “blue bloater” were introduced as a way to show distinct combinations of clinical manifestations, which included cardiovascular comorbidity.[1] More recently, researchers have attempted to identify phenotypes of COPD and pointed out the prominent role of comorbidities.[2] Comorbidities such as cardiovascular diseases, diabetes mellitus, depression, and musculoskeletal disorders are more prevalent in COPD patients than in sexand age-matched healthy individuals.[3] Besides reducing patients’ health-related quality of life,[4] comorbidities are associated with an increased risk of all-cause hospital admission and death,[5] and they contribute to more health-care use and cost.[6].
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