Dueñas-Espín Iván, Demeyer Heleen, Gimeno-Santos Elena, Polkey Michael I, Hopkinson Nicholas S, Rabinovich Roberto A, Dobbels Fabienne, Karlsson Niklas, Troosters Thierry, Garcia-Aymerich Judith
ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBEREpidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Secretaría Nacional de Educación Superior, Ciencia, Tecnología e Innovación del Ecuador (SENESCYT), Quito, Ecuador; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
Int J Chron Obstruct Pulmon Dis. 2016 Jun 10;11:1287-95. doi: 10.2147/COPD.S101459. eCollection 2016.
The role of anxiety and depression in the physical activity (PA) of patients with COPD is controversial. We prospectively assessed the effect of symptoms of anxiety and depression on PA in COPD patients.
We evaluated anxiety and depression (Hospital Anxiety and Depression Scale [HADS]), PA (Dynaport(®) accelerometer), and other relevant characteristics in 220 COPD patients from five European countries at baseline and at 6 and 12 months of follow-up. HADS score was categorized as: no symptoms (score 0-7), suggested (8-10), and probable (>11) anxiety or depression. We estimated the association between anxiety and depression at t (baseline and 6 months) and PA at t+1 (6 and 12 months) using regression models with a repeated measures approach.
Patients had a mean (standard deviation) age of 67 (8) years, forced expiratory volume in 1 second 57 (20)% predicted. At baseline, the prevalence of probable anxiety and depression was 10% and 5%, respectively. In multivariable models adjusted by confounders and previous PA, patients performed 81 fewer steps/day (95% confidence interval, -149 to -12, P=0.02) per extra point in HADS-depression score. HADS-anxiety symptoms were not associated with PA.
In COPD patients, symptoms of depression are prospectively associated with a measurable reduction in PA 6 months later.
焦虑和抑郁在慢性阻塞性肺疾病（COPD）患者体力活动（PA）中的作用存在争议。我们前瞻性地评估了焦虑和抑郁症状对COPD患者PA的影响。
我们在基线以及随访6个月和12个月时，对来自五个欧洲国家的220例COPD患者的焦虑和抑郁（医院焦虑抑郁量表[HADS]）、PA（Dynaport（®）加速度计）及其他相关特征进行了评估。HADS评分分为：无症状（评分0 - 7）、疑似（8 - 10）以及可能存在（>11）焦虑或抑郁。我们采用重复测量方法，通过回归模型估计t（基线和6个月时）的焦虑和抑郁与t + 1（6个月和12个月时）的PA之间的关联。
患者的平均（标准差）年龄为67（8）岁，第1秒用力呼气量为预测值的57（20）%。在基线时，可能存在焦虑和抑郁的患病率分别为10%和5%。在经混杂因素和既往PA校正的多变量模型中，HADS抑郁评分每增加1分，患者每天少走81步（95%置信区间，-149至-12，P = 0.02）。HADS焦虑症状与PA无关。
在COPD患者中，抑郁症状与6个月后可测量的PA减少存在前瞻性关联。
