Chest
Original ResearchCOPDPatients With COPD With Higher Levels of Anxiety Are More Physically Active
Section snippets
Study Design and Settings
The COPD Activity: Serotonin Transporter, Cytokine, and Depression Study (CASCADE) is an ongoing, multisite, prospective, observational study of subjects with COPD who are being followed for 2 years to study the biologic causes and functional consequences of depression. This manuscript is a cross-sectional, descriptive analysis of data from 148 subjects collected at entry to CASCADE. This study was approved by the respective institutional review boards at three clinical sites: the University of
Patient Characteristics
Table 1 includes the summary of the demographic and baseline characteristics of the 148 patients included in the analysis. The cohort (78% men) had a mean FEV1 % predicted of 42% and few comorbidities. Overall, participants were relatively high functioning and had relatively low depressive and anxiety symptoms. Approximately 32% and 29% of patients scored higher than 8 points on the HADS-A and HADS-D, respectively. Mean SAM wear time did not differ between subjects who had high- or low-anxiety
Discussion
A key novel finding of this study is that anxiety was significantly and independently associated with increased ambulatory PA in patients with severe COPD, even after adjusting for relevant covariates including demographics, disease severity, functional capacity, dyspnea, and depression. To our knowledge, this finding has not been published elsewhere. We performed a number of diagnostic tests to ensure that the models met the assumptions for linear regression, and, thus, we believe these
Conclusions
We conclude that anxiety is associated with increased daily PA in a selected sample of patients with COPD. It is unclear whether patients with COPD who have higher levels of anxiety are more restless and use increased psychomotor activity as a coping mechanism, or whether those with COPD who push themselves to be more physically active experience more anxiety symptoms. The clinical implications of these observations are interesting because anxiety as a comorbid disorder is associated with
Acknowledgments
Author contributions: Dr Nguyen had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Dr Nguyen: contributed to the study design, data analysis and interpretation, and preparation of the manuscript and served as principal author.
Dr Fan: contributed to the study design, data analysis and interpretation, and preparation of the manuscript.
Dr Herting: contributed to the study design, data analysis and
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2018, Heart and LungCitation Excerpt :The current analyses differed from the prior study in that it included both objective and subjective measurements for physical performance as opposed to objectively measured daily step counts alone. It was suggested that increased daily steps may be a behavioral manifestation of the restlessness, or as non-goal directed activities from high levels of anxious symptoms.37 An anxious mind may result in not sitting or resting still, however it should not be interpreted as an improvement in physical performance due to higher levels of anxiety.
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2016, Contemporary Clinical TrialsCitation Excerpt :Eighty-nine research studies published between 1999 and 2014 were identified through a PubMed search in January 2015 for published articles containing both “COPD” and “Activity” in the article title and/or abstract; with additionally at least one of the following search terms: “Pedometer”, “Accelerometer” and “Accelerometry”. The list was subsequently reduced to 76 studies [12–87] after review articles (n = 2), clinic-only investigations (n = 5), algorithm development and validation studies (n = 1), studies not using an activity monitor (n = 1), studies not investigating COPD subjects (n = 1), and foreign language articles without an English translation available (n = 3) were removed. Of the 76 studies, our review contained 42 cross-sectional studies, 18 intervention studies (either using an activity monitor as a component of an intervention or to measure the impact or an intervention), 3 longitudinal studies and 13 measurement studies (e.g. assessing the measurement qualities of the activity measure).
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2015, ChestCitation Excerpt :Thus, respiratory mechanical factors appear to be less important than increased central neural drive in explaining dyspnea, at least in patients with mild to moderate obesity.8 Both anxiety and depression are more prevalent in patients with various cardiac and respiratory diseases.9‐11 These psychologic conditions are related to a less favorable course of disease11 and increase the risk of worse COPD outcomes.12
Funding/Support: This work was supported in part by grants from the US National Institutes of Health (NIH) National Heart, Lung, and Blood Institute [5R01HL093146] and the NIH National Center for Research Resources [UL1RR025014]. Dr Fan has funding through the Department of Veterans Affairs.
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