How to determine an impaired health status in COPD: Results from a population-based study

D. E. Smid*, M. A. Spruit, D. J. H. Deeg, M. Huisman, J. Poppelaars, E. F. M. Wouters, F. M. E. Franssen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background: Chronic obstructive pulmonary disease ( COPD) is associated with a significantly impaired health status and lost work productivity across all degrees of airflow limitation. The current study investigated whether an impaired health status is better represented by the recommended COPD Assessment Test (CAT) cut-point of I0 points, or the 95(th) percentile of the CAT score in a non-COPD population. Additionally, the impact of COPD on health status in a Dutch population, after stratification for work status, was measured.

Methods: Demographics, clinical characteristics, post-bronchodilator spirometry, and CAT were assessed in subjects from the Longitudinal Aging Study Amsterdam ( LASA), a large Dutch population-based study. Normative values for the CAT score were described by percentiles using the mean, standard deviation, median and range.

Results: In total, 8I0 COPD and non-COPD subjects (50.4% male, mean age 60.5 +/- 2.9 years) were analysed. Significant differences were observed in CAT scores between non-COPD and COPD subjects (6.7 +/- 5.2 vs. 9.5 +/- 5.9, p <0.001 respectively). The proportion of COPD subjects with an impaired health status differed between applying the CAT >= I0 cut-point (50.0%) and applying the 95th percentile of CAT in non-COPD subjects (> I8 cut-point; 7.6%). Higher CAT scores were seen in working COPD patients compared with working non-COPD subjects (9.3 +/- 5.2 vs. 6.0 +/- 4.6, p <0.001).

Conclusion: We suggest a CAT cut-point of > I8 points to indicate an impaired health status in COPD. This would imply an adaptation of the current GOLD classification of the disease.

Original languageEnglish
Pages (from-to)151-157
Number of pages7
JournalNetherlands Journal of Medicine
Issue number4
Publication statusPublished - May 2017


  • Health status
  • Chronic Obstructive Pulmonary Disease (COPD)
  • COPD assessment test
  • normative values
  • AGE


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