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Associations of total and type-specific physical activity with mortality in chronic obstructive pulmonary disease: a population-based cohort study.

ABSTRACT: Regular physical activity is recommended for all people with chronic obstructive pulmonary disease (COPD), but the dose of physical activity required to gain mortality benefit in this population is not yet known. This aim of this study was to examine the associations of total and type-specific physical activity with mortality risk in people with COPD.People with COPD aged ?40 years were identified from the 1997 Health Survey for England and the 1998 and 2003 Scottish Health Survey cohorts. Self-reported total physical activity, moderate-vigorous intensity physical activity (MVPA), walking, domestic physical activity, and sport/exercise were assessed at baseline. Cox proportional hazards models were used to examine the associations between physical activity and mortality risk.Two thousand three hundred ninety-eight participants with COPD were included in the analysis and followed up for a mean 8.5 (SD 3.9) years. For both total physical activity and MVPA, we observed dose-response associations with all-cause and cardiovascular disease (CVD) mortality risk, and with respiratory mortality risk to a lesser extent. Compared to those who reported no physical activity, participants who met the physical activity guidelines demonstrated the greatest reductions in all-cause (HR 0.56, 95% CI 0.45-0.69), CVD (HR 0.48, 95% CI 0.32-0.71) and respiratory mortality risk (HR 0.40, 95% CI 0.24-0.67). Participants who reported a level of physical activity of at least half the dosage recommended by the guidelines also had a reduced risk of all-cause (HR 0.75, 95% CI 0.56-1.00) and CVD mortality (HR 0.48, 95% CI 0.26-0.88). Dose-response associations with mortality risk were demonstrated for walking and sport/exercise, but not domestic physical activity.We found a dose-response association between physical activity and all-cause and CVD mortality risk in people with COPD, with protective effects appearing at levels considerably lower than the general physical activity recommendations. People with COPD may benefit from engagement in low levels of physical activity, particularly walking and structured exercise.

SUBMITTER: Cheng SWM

PROVIDER: S-EPMC5816365 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

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Associations of total and type-specific physical activity with mortality in chronic obstructive pulmonary disease: a population-based cohort study.

Cheng Sonia Wing Mei SWM McKeough Zoe Z Alison Jennifer J Dennis Sarah S Hamer Mark M Stamatakis Emmanuel E

BMC public health 20180217 1

<h4>Background</h4>Regular physical activity is recommended for all people with chronic obstructive pulmonary disease (COPD), but the dose of physical activity required to gain mortality benefit in this population is not yet known. This aim of this study was to examine the associations of total and type-specific physical activity with mortality risk in people with COPD.<h4>Methods</h4>People with COPD aged ≥40 years were identified from the 1997 Health Survey for England and the 1998 and 2003 Sc ...[more]

PMID: 29454345

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Project description:Multi-morbidity is common in patients with chronic obstructive pulmonary disease and low levels of physical activity are hypothesized to be an important risk factor. The current study aimed to assess the longitudinal association between physical activity and risk of seven categories of comorbidity in chronic obstructive pulmonary disease patients. The study included 409 patients from primary care practice in the Netherlands and Switzerland. We assessed physical activity using the Longitudinal Ageing Study Amsterdam Physical Activity Questionnaire at baseline and followed patients for up to 5 years. During follow-up, patients reported their comorbidities (cardiovascular, neurological, endocrine, musculoskeletal, malignant, and infectious diseases) and completed the Hospital Anxiety and Depression Scale questionnaire for mental health assessment. We implemented multinomial logistic regression (an approximation to discrete time survival model using death as a competing risk) for our analysis. Study results did not suggest a statistically significant association of baseline physical activity with the development of seven categories of comorbidity. However, when we focused on depression and anxiety symptoms, we found that higher levels of physical activity at baseline were associated with a lower risk for depression (adjusted hazard ratio, 0.85; 0.75-0.95; p?=?0.005) and anxiety (adjusted hazard ratio, 0.89; 0.79-1.00; p?=?0.045). In chronic obstructive pulmonary disease patients, those with high physical activity are less likely to develop depression or anxiety symptoms over time. Increasing physical activity in chronic obstructive pulmonary disease patients may be an approach for testing to lower the burden from incident depression and anxiety.STAY ACTIVE TO AVOID DEPRESSION AND ANXIETY: Patients with chronic lung disease who stay physically active could reduce their chances of depression and anxiety. Milo Puhan at the University of Zurich, Switzerland, and co-workers assessed the association between physical activity and the risk of developing various co-existing diseases in 409 patients with chronic obstructive pulmonary disease (COPD). Co-morbidities such as cardiovascular diseases, diabetes and depression are prevalent in patients with COPD, but the reasons why are not clear. Puhan's team assessed patients' activity levels using an existing questionnaire, and administered another questionnaire to assess mental health. They followed the cohort for 5 years. Results indicated weak associations between physical activity levels and most physical illnesses, but there were significant links between higher levels of physical activity and a reduced risk of depression and anxiety. The results could inform novel COPD treatment programs.

Dataset Information

Associations of total and type-specific physical activity with mortality in chronic obstructive pulmonary disease: a population-based cohort study.

Publications

Associations of total and type-specific physical activity with mortality in chronic obstructive pulmonary disease: a population-based cohort study.

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