The impact of COPD on health status: findings from the BOLD study

• Published in: The European respiratory journal Vol. 42; no. 6; pp. 1472 - 1483
• Main Authors: Janson, Christer, Marks, Guy, Buist, Sonia, Gnatiuc, Louisa, Gislason, Thorarinn, McBurnie, Mary Ann, Nielsen, Rune, Studnicka, Michael, Toelle, Brett, Benediktsdottir, Bryndis, Burney, Peter
• Format: Journal Article
• Language: English
• Published: Leeds Maney 01.12.2013; European Respiratory Society
• Subjects: Adult; Biological and medical sciences; Body Mass Index; Chronic obstructive pulmonary disease, asthma; Comorbidity; Cross-Sectional Studies; Dyspnea - physiopathology; Female; Forced Expiratory Volume; Health Status; Humans; International Cooperation; Lung - physiopathology; Male; Medical sciences; Middle Aged; Multivariate Analysis; Original; Pneumology; Pulmonary Disease, Chronic Obstructive - physiopathology; Spirometry; Surveys and Questionnaires; Vital Capacity; Lung disease; Chronic; Health status; Respiratory disease; Health; Bronchus disease; Chronic obstructive pulmonary disease; Obstructive pulmonary disease
• ISSN: 0903-1936; 1399-3003; 1399-3003
• DOI: 10.1183/09031936.00153712

The aim of this study was to describe the impact of chronic obstructive pulmonary disease (COPD) on health status in the Burden of Obstructive Lung Disease (BOLD) populations. We conducted a cross-sectional, general population-based survey in 11 985 subjects from 17 countries. We measured spirometric lung function and assessed health status using the Short Form 12 questionnaire. The physical and mental health component scores were calculated. Subjects with COPD (post-bronchodilator forced expiratory volume in 1 s/forced vital capacity <0.70, n = 2269) had lower physical component scores (44±10 versus 48±10 units, p<0.0001) and mental health component scores (51±10 versus 52±10 units, p = 0.005) than subjects without COPD. The effect of reported heart disease, hypertension and diabetes on physical health component scores (-3 to -4 units) was considerably less than the effect of COPD Global Initiative for Chronic Obstructive Lung Disease grade 3 (-8 units) or 4 (-11 units). Dyspnoea was the most important determinant of a low physical and mental health component scores. In addition, lower forced expiratory volume in 1 s, chronic cough, chronic phlegm and the presence of comorbidities were all associated with a lower physical health component score. COPD is associated with poorer health status but the effect is stronger on the physical than the mental aspects of health status. Severe COPD has a greater negative impact on health status than self-reported cardiovascular disease and diabetes.