Channing Division of Network Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, 02115, USA.
Division of Pulmonary and Critical Care Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Ilsan, Republic of Korea.
Respir Res. 2022 Jan 29;23(1):19. doi: 10.1186/s12931-021-01922-6.
Optimism is the general belief that good things will occur in the future; optimism is modifiable by cognitive behavioral therapy (CBT). Previous studies have associated higher optimism with improved health outcomes and lower all-cause mortality.
Investigate association between optimism and disease-related characteristics in chronic obstructive pulmonary disease (COPD).
Current and former smokers with/without COPD and Preserved Ratio Impaired Spirometry (PRISm) from the 10-year follow-up visit for the Genetic Epidemiology of COPD (COPDGene) study were included. Optimism was assessed at the 10-year visit using the Life Orientation Test-Revised. Models of optimism as a predictor of lung function, COPD-associated phenotypes including exacerbations, and functional assessments, were adjusted for demographic confounders, smoking status, and comorbidities.
Among 1967 subjects, higher optimism was significantly associated with older age, non-Hispanic white race, marital status, quitting smoking status, absence of COPD, and absence of depression. In multivariable analysis, higher optimism was independently associated with fewer prior exacerbations of COPD (coef = - 0.037, P < 0.001). Higher optimism was also related to better MMRC scores (coef = - 0.041, P < 0.001), CAT scores (coef = - 0.391, P < 0.001), SGRQ scores (coef = - 0.958, P < 0.001), BODE index (coef = - 0.059, P < 0.001), and longer 6-min walk distance (coef = 10.227, P < 0.001). After stratification by severity of COPD, these associations with optimism were still significant in all groups. No significant association was observed for cross-sectional FEV (%) or FVC (%) with optimism score.
Fewer exacerbations and less severe respiratory symptoms and higher functional capacity were associated with higher optimism, which may impact health outcomes in current and former smokers with and without COPD. Optimism is a modifiable trait and these results may further support a role for CBT to improve outcomes in COPD.
乐观主义是对未来会发生好事的普遍信念；乐观主义可以通过认知行为疗法（CBT）来改变。先前的研究表明，较高的乐观主义与改善健康结果和降低全因死亡率相关。
研究慢性阻塞性肺疾病（COPD）中乐观主义与疾病相关特征之间的关联。
本研究纳入了来自 COPDGene 研究 10 年随访的当前吸烟者、既往吸烟者、有/无 COPD 和保留比受损肺活量（PRISm）患者。在 10 年随访时使用生活取向测试修订版（Life Orientation Test-Revised）评估乐观主义。将乐观主义作为预测因素的模型用于评估肺功能、COPD 相关表型（包括加重）和功能评估，调整了人口统计学混杂因素、吸烟状况和合并症。
在 1967 名受试者中，较高的乐观主义与年龄较大、非西班牙裔白人种族、婚姻状况、戒烟状况、无 COPD 和无抑郁显著相关。在多变量分析中，较高的乐观主义与较少的 COPD 加重次数独立相关（系数= - 0.037，P < 0.001）。较高的乐观主义也与更好的 MMRC 评分（系数= - 0.041，P < 0.001）、CAT 评分（系数= - 0.391，P < 0.001）、SGRQ 评分（系数= - 0.958，P < 0.001）、BODE 指数（系数= - 0.059，P < 0.001）和更长的 6 分钟步行距离（系数= 10.227，P < 0.001）相关。按 COPD 严重程度分层后，在所有组中，这些与乐观主义的关联仍然显著。乐观主义评分与横断面 FEV（%）或 FVC（%）之间无显著相关性。
较少的加重次数、较轻的呼吸症状和更高的功能能力与较高的乐观主义相关，这可能会影响当前吸烟者和既往吸烟者中有无 COPD 的健康结果。乐观主义是一种可改变的特征，这些结果可能进一步支持认知行为疗法在 COPD 中的作用，以改善结果。
