TY - JOUR
T1 - Disease Progression and Age as Factors Underlying Multimorbidity in Patients with COPD
T2 - Results from COSYCONET
AU - Alter, Peter
AU - Kahnert, Kathrin
AU - Trudzinski, Franziska C
AU - Bals, Robert
AU - Watz, Henrik
AU - Speicher, Tim
AU - Söhler, Sandra
AU - Andreas, Stefan
AU - Welte, Tobias
AU - Rabe, Klaus F
AU - Wouters, Emiel F M
AU - Sassmann-Schweda, Antonia
AU - Wirtz, Hubert
AU - Ficker, Joachim H
AU - Vogelmeier, Claus F
AU - Jörres, Rudolf A
N1 - © 2022 Alter et al.
PY - 2022
Y1 - 2022
N2 - Background: Multimorbidity plays an important role in chronic obstructive pulmonary disease (COPD) but is also a feature of ageing. We estimated to what extent increases in the prevalence of multimorbidity over time are attributable to COPD progression compared to increasing patient age.Methods: Patients with COPD from the long-term COSYCONET (COPD and Systemic Consequences - Comorbidities Network) cohort with four follow-up visits were included in this analysis. At each visit, symptoms, exacerbation history, quality of life and lung function were assessed, along with the comorbidities heart failure (HF), coronary artery disease (CAD), peripheral arterial disease (PAD), hypertension, sleep apnea, diabetes mellitus, hyperlipidemia, hyperuricemia and osteoporosis. Using longitudinal logistic regression analysis, we determined what proportion of the increase in the prevalence of comorbidities could be attributed to patients' age or to the progression of COPD over visits.Results: Of 2030 patients at baseline, 878 completed four follow-up visits (up to 4.5 years). CAD prevalence increased over time, with similar effects attributable to the 4.5-year follow-up, used as indicator of COPD progression, and to a 5-year increase in patients' age. The prevalence of HF, diabetes, hyperlipidemia, hyperuricemia, osteoporosis and sleep apnea showed stronger contributions of COPD progression than of age; in contrast, age dominated for hypertension and PAD. There were different relationships to patients' characteristics including BMI and sex. The results were not critically dependent on the duration of COPD prior to enrolment, or the inclusion of patients with all four follow-up visits vs those attending only at least one of them.Conclusion: Analyzing the increasing prevalence of multimorbidity in COPD over time, we separated age-independent contributions, probably reflecting intrinsic COPD-related disease progression, from age-dependent contributions. This distinction might be useful for the individual assessment of disease progression in COPD.
AB - Background: Multimorbidity plays an important role in chronic obstructive pulmonary disease (COPD) but is also a feature of ageing. We estimated to what extent increases in the prevalence of multimorbidity over time are attributable to COPD progression compared to increasing patient age.Methods: Patients with COPD from the long-term COSYCONET (COPD and Systemic Consequences - Comorbidities Network) cohort with four follow-up visits were included in this analysis. At each visit, symptoms, exacerbation history, quality of life and lung function were assessed, along with the comorbidities heart failure (HF), coronary artery disease (CAD), peripheral arterial disease (PAD), hypertension, sleep apnea, diabetes mellitus, hyperlipidemia, hyperuricemia and osteoporosis. Using longitudinal logistic regression analysis, we determined what proportion of the increase in the prevalence of comorbidities could be attributed to patients' age or to the progression of COPD over visits.Results: Of 2030 patients at baseline, 878 completed four follow-up visits (up to 4.5 years). CAD prevalence increased over time, with similar effects attributable to the 4.5-year follow-up, used as indicator of COPD progression, and to a 5-year increase in patients' age. The prevalence of HF, diabetes, hyperlipidemia, hyperuricemia, osteoporosis and sleep apnea showed stronger contributions of COPD progression than of age; in contrast, age dominated for hypertension and PAD. There were different relationships to patients' characteristics including BMI and sex. The results were not critically dependent on the duration of COPD prior to enrolment, or the inclusion of patients with all four follow-up visits vs those attending only at least one of them.Conclusion: Analyzing the increasing prevalence of multimorbidity in COPD over time, we separated age-independent contributions, probably reflecting intrinsic COPD-related disease progression, from age-dependent contributions. This distinction might be useful for the individual assessment of disease progression in COPD.
KW - Diabetes Mellitus/diagnosis
KW - Disease Progression
KW - Humans
KW - Hyperlipidemias
KW - Hypertension/epidemiology
KW - Hyperuricemia/diagnosis
KW - Multimorbidity
KW - Osteoporosis/diagnosis
KW - Pulmonary Disease, Chronic Obstructive/diagnosis
KW - Quality of Life
KW - Sleep Apnea Syndromes
KW - multimorbidity
KW - disease progression
KW - PREVALENCE
KW - prognosis
KW - comorbidities
KW - COMORBIDITIES
KW - chronic obstructive pulmonary disease
U2 - 10.2147/COPD.S364812
DO - 10.2147/COPD.S364812
M3 - Article
C2 - 35936574
SN - 1178-2005
VL - 17
SP - 1703
EP - 1713
JO - International journal of chronic obstructive pulmonary disease
JF - International journal of chronic obstructive pulmonary disease
ER -