From the Ferkauf Graduate School of Psychology (Feldman, Greenfield, Wiviott), Yeshiva University; Division of Academic General Pediatrics, Department of Pediatrics (Feldman, DeLeon, Torres-Hernandez), Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx; Division of General Internal Medicine (Becker, Arora, Federman, Wisnivesky), Icahn School of Medicine at Mount Sinai, New York; Division of Allergy/Immunology, Department of Medicine (Jariwala), Albert Einstein College of Medicine/Montefiore Medical Center; Division of Pulmonary Medicine, Department of Medicine (Shim), Jacobi Medical Center/Albert Einstein College of Medicine, Bronx; and Division of Pulmonary, Critical Care and Sleep Medicine (Wisnivesky), Icahn School of Medicine at Mount Sinai, New York, New York.
Psychosom Med. 2021 Sep 1;83(7):787-794. doi: 10.1097/PSY.0000000000000951.
Older adults are at increased risk for depression and poor asthma outcomes. We examined whether depressive symptoms are associated with overperception of airflow obstruction and a pattern of worse asthma control, but not pulmonary function.
We recruited a cohort of adults with asthma 60 years and older in East Harlem and the Bronx, New York. Baseline measures included the Geriatric Depression Scale, Asthma Control Questionnaire, and Mini Asthma Quality of Life Questionnaire. Spirometry was conducted at baseline to assess pulmonary function. Perception of airflow obstruction was assessed for 6 weeks following baseline by participants entering estimates of peak expiratory flow (PEF) into a programmable peak flow meter followed by PEF blows. Participants were blinded to actual PEF values. The percentage of time that participants were in the overperception zone was calculated as an average.
Among the 334 participants (51% Hispanic, 25% Black), depressive symptoms were associated with overperception of airflow obstruction (β = 0.14, p = .029), worse self-reported asthma control (β = 0.17, p = .003), and lower asthma-related quality of life (β = -0.33, p < .001), but not with lung function (β = -0.01, p = .82). Overperception was also associated with worse self-reported asthma control (β = 0.14, p = .021), but not lung function (β = -0.05, p = .41).
Depressive symptoms were associated with greater perceived impairment from asthma, but not pulmonary function. Overperception of asthma symptoms may play a key role in the relationship between depression and asthma outcomes in older adults.
老年人患抑郁症和哮喘预后不良的风险增加。我们研究了抑郁症状是否与气流阻塞的过度感知以及哮喘控制恶化模式相关，但与肺功能无关。
我们在纽约东哈莱姆和布朗克斯招募了一个 60 岁及以上的哮喘成年人队列。基线测量包括老年抑郁量表、哮喘控制问卷和迷你哮喘生活质量问卷。基线时进行肺功能检查以评估肺功能。在基线后 6 周内，参与者通过将呼气峰值流量 (PEF) 的估计值输入可编程峰值流量计，然后进行 PEF 吹气，来评估气流阻塞的感知。参与者对实际的 PEF 值一无所知。参与者处于过度感知区域的时间百分比作为平均值进行计算。
在 334 名参与者（51%为西班牙裔，25%为黑人）中，抑郁症状与气流阻塞的过度感知（β=0.14，p=0.029）、自我报告的哮喘控制恶化（β=0.17，p=0.003）和哮喘相关生活质量降低（β=-0.33，p<0.001）相关，但与肺功能无关（β=-0.01，p=0.82）。过度感知也与自我报告的哮喘控制恶化相关（β=0.14，p=0.021），但与肺功能无关（β=-0.05，p=0.41）。
抑郁症状与对哮喘的感知损害更大相关，而与肺功能无关。对哮喘症状的过度感知可能在老年人抑郁和哮喘结局之间的关系中起关键作用。
