Holm Kristen E, Plaufcan Melissa R, Ford Dee W, Sandhaus Robert A, Strand Matthew, Strange Charlie, Wamboldt Frederick S
Department of Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO, 80206, USA,
J Behav Med. 2014 Aug;37(4):654-63. doi: 10.1007/s10865-013-9516-7. Epub 2013 May 4.
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.
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。