Chest
Original ResearchCOPDPatients With COPD With Higher Levels of Anxiety Are More Physically Active
Section snippets
Study Design and Settings
The COPD Activity: Serotonin Transporter, Cytokine, and Depression Study (CASCADE) is an ongoing, multisite, prospective, observational study of subjects with COPD who are being followed for 2 years to study the biologic causes and functional consequences of depression. This manuscript is a cross-sectional, descriptive analysis of data from 148 subjects collected at entry to CASCADE. This study was approved by the respective institutional review boards at three clinical sites: the University of
Patient Characteristics
Table 1 includes the summary of the demographic and baseline characteristics of the 148 patients included in the analysis. The cohort (78% men) had a mean FEV1 % predicted of 42% and few comorbidities. Overall, participants were relatively high functioning and had relatively low depressive and anxiety symptoms. Approximately 32% and 29% of patients scored higher than 8 points on the HADS-A and HADS-D, respectively. Mean SAM wear time did not differ between subjects who had high- or low-anxiety
Discussion
A key novel finding of this study is that anxiety was significantly and independently associated with increased ambulatory PA in patients with severe COPD, even after adjusting for relevant covariates including demographics, disease severity, functional capacity, dyspnea, and depression. To our knowledge, this finding has not been published elsewhere. We performed a number of diagnostic tests to ensure that the models met the assumptions for linear regression, and, thus, we believe these
Conclusions
We conclude that anxiety is associated with increased daily PA in a selected sample of patients with COPD. It is unclear whether patients with COPD who have higher levels of anxiety are more restless and use increased psychomotor activity as a coping mechanism, or whether those with COPD who push themselves to be more physically active experience more anxiety symptoms. The clinical implications of these observations are interesting because anxiety as a comorbid disorder is associated with
Acknowledgments
Author contributions: Dr Nguyen had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Dr Nguyen: contributed to the study design, data analysis and interpretation, and preparation of the manuscript and served as principal author.
Dr Fan: contributed to the study design, data analysis and interpretation, and preparation of the manuscript.
Dr Herting: contributed to the study design, data analysis and
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Funding/Support: This work was supported in part by grants from the US National Institutes of Health (NIH) National Heart, Lung, and Blood Institute [5R01HL093146] and the NIH National Center for Research Resources [UL1RR025014]. Dr Fan has funding through the Department of Veterans Affairs.
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