title: Emphysema on imaging is associated with quality of life in elderly patients with chronic obstructive pulmonary disease.
abstract: BACKGROUND
  Limited data are available on the association between the severity of emphysema or airway narrowing, and health-related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease (COPD), which has been seen to be more prevalent among elderly subjects. The aim of this study was to examine the association between HRQOL, physical parameters and structural alterations in lung of COPD patients.
  
  
  METHODS
  Stable COPD patients (n = 125; mean age 71.0) were studied. Both the severity of emphysema, which was expressed as the extent of the low-attenuation area (LAA%), and percentage of the large airway wall area (WA%) on high-resolution computed tomography (HRCT) were compared with various parameters of the generic and HRQOL, respectively, together with pulmonary function tests and exercise capacity.
  
  
  RESULTS
  The predicted value of forced expiratory volume in 1 s was significantly associated with both LAA% and WA%, but the diffusion capacity was strongly correlated with LAA% alone. Parameters of the generic and HRQOL, and almost all other parameters appeared to be significantly associated with LAA% alone, whereas no association was observed between WA% and QOL.
  
  
  CONCLUSIONS
  We concluded that the severity of emphysema, but not that of large airway narrowing on HRCT, is associated with both generic and health-related QOL and reduced diffusion capacity. This notion might provide useful information in practice among elderly subjects who are unable to perform a spirometry.
authors.affiliation: Department of Pulmonary Medicine, Infection and Oncology, The Respiratory Care Clinic, Nippon Medical School, Tokyo, Japan.
authors.forename: Norihisa
authors.initials: N
authors.lastname: Motohashi
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Kimura
authors.forename: Takeo
authors.initials: T
authors.lastname: Ishii
authors.forename: Ritsuko
authors.initials: R
authors.lastname: Wakabayashi
authors.forename: Hiroko
authors.initials: H
authors.lastname: Kurosaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Motegi
authors.forename: Kouichi
authors.initials: K
authors.lastname: Yamada
authors.forename: Rupert C M
authors.initials: RC
authors.lastname: Jones
authors.forename: Akihiko
authors.initials: A
authors.lastname: Gemma
authors.forename: Kozui
authors.initials: K
authors.lastname: Kida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000000981:diagnostic imaging*; D011656:Pulmonary Emphysema / Q000150:complications / Q000000981:diagnostic imaging*; D011788:Quality of Life; D012129:Respiratory Function Tests; D036542:Tomography, Spiral Computed