Depression in elderly outpatients with disabling chronic obstructive pulmonary disease

• Published in: Age and ageing Vol. 27; no. 2; pp. 155 - 160
• Main Authors: YOHANNES, ABEBW M., ROOMI, JAMAL, BALDWIN, ROBERT C., CONNOLLY, MARTIN J.
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01-03-1998
• Subjects: Aged; Aged, 80 and over; Chronic obstructive pulmonary disease; Depression; Depression - epidemiology; Depression in old age; Disability Evaluation; Dyspnea - epidemiology; Dyspnea - psychology; Elderly people; Female; Forced Expiratory Volume; Geriatric depression; Humans; Influence; Lung diseases; Male; outpatients; Outpatients - psychology; Outpatients - statistics & numerical data; Prevalence; Pulmonary Disease, Chronic Obstructive - epidemiology; Pulmonary Disease, Chronic Obstructive - psychology; Quality of Life; Regression Analysis; Severity of Illness Index; Spirometry
• ISSN: 0002-0729; 1468-2834
• DOI: 10.1093/ageing/27.2.155

Introduction: depression is common in both young adults and elderly people with chronic obstructive pulmonary disease (COPD). Methods: we compared the prevalence of depressive symptomatology in elderly outpatients with stable disabling COPD with that in healthy controls and age-matched patients with other disabilities, and also assessed the relation between degree of disability, quality of life and depressive symptoms. The subjects were 96 older people with COPD [56 men; aged 70–93 (mean 78) years], 55 normal controls [23 men; aged 70–90 (mean 78) years] and 53 disabled controls [27 men; aged 70–92 (mean 78) years]. Exclusion criteria were acute respiratory exacerbation or use of oral steroids in the last 6 weeks, known previous psychiatric disorder and acute or chronic confusion. Results: mean (and SD) values for 1-s forced expiratory volume (FEV1) were 51 (20) % in COPD subjects, 107 (24) % in normal controls and 82 (13)% in disabled controls. Forty-four subjects with COPD (46%), six normal controls (11%) and 14 disabled controls (26%) scored in the ‘caseness’ range for depressive ideation on the Brief Assessment Schedule Depression Cards (BASDEC) screening questionnaire. A multiple regression analysis was performed for the COPD group to identify factors predictive of BASDEC score. Predictive variables were total quality of life score [P < 0.0001], Chronic Respiratory Questionnaire and level of activities of daily living (Nottingham extended activities of daily living scale) [P = 0.001]. Spirometry results and exercise tolerance (6-min walk distance) did not help predict BASDEC score (R2 = 0.50). Conclusions: depressive symptoms are common in elderly patients with COPD; prevalence and/or severity of depressive symptoms may be greater in those who are most disabled.