Disease Progression and Age as Factors Underlying Multimorbidity in Patients with COPD: Results from COSYCONET

Peter Alter*, Kathrin Kahnert, Franziska C Trudzinski, Robert Bals, Henrik Watz, Tim Speicher, Sandra Söhler, Stefan Andreas, Tobias Welte, Klaus F Rabe, Emiel F M Wouters, Antonia Sassmann-Schweda, Hubert Wirtz, Joachim H Ficker, Claus F Vogelmeier, Rudolf A Jörres

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)1703-1713
Number of pages11
JournalInternational journal of chronic obstructive pulmonary disease
Volume17
DOIs
Publication statusPublished - 2022

Keywords

  • Diabetes Mellitus/diagnosis
  • Disease Progression
  • Humans
  • Hyperlipidemias
  • Hypertension/epidemiology
  • Hyperuricemia/diagnosis
  • Multimorbidity
  • Osteoporosis/diagnosis
  • Pulmonary Disease, Chronic Obstructive/diagnosis
  • Quality of Life
  • Sleep Apnea Syndromes
  • multimorbidity
  • disease progression
  • PREVALENCE
  • prognosis
  • comorbidities
  • COMORBIDITIES
  • chronic obstructive pulmonary disease

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