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年龄对慢性阻塞性肺疾病预后的影响因婚姻状况而异。

The impact of age on outcomes in chronic obstructive pulmonary disease differs by relationship status.

作者信息

Holm Kristen E, Plaufcan Melissa R, Ford Dee W, Sandhaus Robert A, Strand Matthew, Strange Charlie, Wamboldt Frederick S

机构信息

Department of Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO, 80206, USA,

出版信息

J Behav Med. 2014 Aug;37(4):654-63. doi: 10.1007/s10865-013-9516-7. Epub 2013 May 4.

Abstract

Alpha-1 antitrypsin deficiency (AATD) is a genetic condition that can lead to early-onset chronic obstructive pulmonary disease (COPD). The objective of this study was to examine the impact of age on psychological and clinical outcomes among individuals with AATD-associated COPD. 468 individuals with AATD-associated COPD (age 32-84 at baseline) completed questionnaires at baseline, 1- and 2-year follow-up. Age was examined as a predictor of depression, anxiety, health-related quality of life, and breathlessness at all three time points using linear mixed models. Age was associated with anxiety (b = -0.09, SE = 0.02, p < 0.001) and health-related quality of life (b = -0.29, SE = 0.09, p < 0.001). Age also had a statistically significant interaction with relationship status when predicting depression, health-related quality of life, and breathlessness. Among individuals who were single, younger age was associated with more symptoms of depression (b = -0.08, SE = 0.03, p < 0.01), worse health-related quality of life (b = -0.61, SE = 0.16, p < 0.001), and more breathlessness (b = -0.023, SE = 0.009, p < 0.01) throughout the 2-year study. Age was not associated with these three outcomes among individuals who were married/part of an unmarried couple. Results suggest that individuals who develop a chronic illness at a young age, particularly those who are single, may be more likely to have worse psychological and clinical outcomes.

摘要

α-1抗胰蛋白酶缺乏症(AATD)是一种遗传性疾病,可导致早发性慢性阻塞性肺疾病(COPD)。本研究的目的是探讨年龄对AATD相关COPD患者心理和临床结局的影响。468例AATD相关COPD患者(基线年龄32 - 84岁)在基线、1年和2年随访时完成问卷调查。使用线性混合模型在所有三个时间点将年龄作为抑郁、焦虑、健康相关生活质量和呼吸困难的预测指标进行检验。年龄与焦虑(b = -0.09,标准误 = 0.02,p < 0.001)和健康相关生活质量(b = -0.29,标准误 = 0.09,p < 0.001)相关。在预测抑郁、健康相关生活质量和呼吸困难时,年龄与关系状况也存在统计学上的显著交互作用。在单身个体中,较年轻的年龄与更多的抑郁症状(b = -0.08,标准误 = 0.03,p < 0.01)、更差的健康相关生活质量(b = -0.61,标准误 = 0.16,p < 0.001)以及在整个2年研究期间更多的呼吸困难(b = -0.023,标准误 = 0.009,p < 0.01)相关。在已婚/未婚伴侣关系的个体中,年龄与这三个结局无关。结果表明,年轻时患慢性病的个体,尤其是单身个体,可能更有可能出现较差的心理和临床结局。

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