Anxiety Raises Risk for Acute Exacerbations in Older Adults with COPD: Daily Dose

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Last week, we reported on findings from a study published in Frontiers in Medicine that examined the risk factors of anxiety in older adults with chronic obstructive pulmonary disease (COPD) and the effects of the disorder on future acute exacerbation.

The study

Researchers recruited 424 participants with COPD from pulmonary outpatient clinics at Shanghai hospitals between June 2017 to December 2020. Median age of the group was 70 years and the majority were men (89.6%).

Based on scores on the Hamilton Anxiety Rating Scale (HAMA) researchers divided the group into those with anxiety (n = 84) and those without anxiety (n = 340) (HAMA of 14 or greater was defined as COPD with anxiety). At the first visit, they collected data based on a physical examination and recorded acute exacerbations of COPD (AECOPD) frequency and severity in the previous year; follow-up was for 1 year.

The findings

One or more comorbidities affected 86.79% of the participants and more than half (56.13%) reported at least one AECOPD in the previous year.

When the researchers evaluated risk factors for anxiety, greater COPD severity, based on the BODE index score, was associated with a higher risk, with an odds ratio after multivariable adjustment of 2.45 (1.83–3.408; P <.05). Risk of anxiety also was greater based on higher mMRC score (aOR 2.46, 1.86–3.26; P <.05) and was significantly elevated based on higher score on the CAT (aOR 3.55, 2.13–5.91; P <.05).

The team reported that older adults with COPD and more than 1 comorbidity (aOR 5.67, 95% CI, 3.19-10.07; P <.001) and those who experienced AECOPD in the previous year (aOR 4.00, 95% CI, 2.20-2.27; P <.001), were at a greater risk of developing anxiety. Further they found that having anxiety significantly increased the risk of AECOPD within 1 year.

Authors' comment

"In COPD management, routine screening for psychiatric symptoms should be an integral part of clinical work to reduce the risk of anxiety in older COPD patients at an early stage."

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