title: Life event stress and chronic obstructive pulmonary disease (COPD): associations with mental well-being and quality of life in a population-based study.
abstract: OBJECTIVE
  To investigate whether life event stress was associated with greater psychological distress and poorer quality of life in older individuals with chronic obstructive pulmonary disease (COPD), in comparison with their counterparts without COPD.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  A population-based sample (N=497) of individuals aged 65 and above with COPD (postbronchodilatation FEV1/FVC<0.70, N=136) and without COPD (N=277).
  
  
  METHODS
  We measured life event stress, depressive symptoms (GDS, Geriatric Depression Scale), cognitive symptoms and function (CFQ, Cognitive Failures Questionnaire and MMSE, Mini-Mental State Examination), and physical and mental health functional status (SF36-PCS, Physical Health Component Summary and SF36-MCS, Mental Health Component Summary) in participants with and without COPD.
  
  
  RESULTS
  In two-way analysis of variance controlling for potential confounders, life event stress was associated with significant main effects of worse GDS (p<0.001), SF36-PCS (p=0.008) and SF36-MCS scores (p<0.001), and with significant interaction effects on GDS score (p<0.001), SF36-PCS (p=0.045) and SF36-MCS (p=0.034) in participants with COPD, more than in non-COPD participants. The main effect of COPD was found for postbronchodilator FEV1 (p<0.001) and cognitive symptoms (p=0.02).
  
  
  CONCLUSIONS
  Our findings indicate that life event stress was associated with more depressive symptoms and worse quality of life in individuals with COPD, much more than in those without COPD. Further studies should explore the role of cognitive appraisal of stress, coping resources and psycho-social support in this relationship.
authors.affiliation: Gerontological Research Programme,  Yong Loo Lin School of Medicine, National University of Singapore, Singapore,  Singapore.
authors.forename: Yanxia
authors.initials: Y
authors.lastname: Lu
authors.forename: Ma Shwe Zin
authors.initials: MS
authors.lastname: Nyunt
authors.forename: Xinyi
authors.initials: X
authors.lastname: Gwee
authors.forename: Liang
authors.initials: L
authors.lastname: Feng
authors.forename: Lei
authors.initials: L
authors.lastname: Feng
authors.forename: Ee Heok
authors.initials: EH
authors.lastname: Kua
authors.forename: Rajeev
authors.initials: R
authors.lastname: Kumar
authors.forename: Tze Pin
authors.initials: TP
authors.lastname: Ng