title: Differences in adjustment between individuals with alpha-1 antitrypsin deficiency (AATD)-associated COPD and non-AATD COPD.
abstract: Smokers who have severe alpha-1 antitrypsin deficiency (AATD) are at risk for developing COPD earlier in life than smokers without AATD, and are likely to experience challenges adjusting to their illness because they are in a highly productive life stage when they are diagnosed with COPD. This study examined whether individuals with AATD-associated COPD differ from individuals with non-AATD COPD with regard to depression, anxiety, dyspnea, and health-related quality of life (HRQL). Cross-sectional data were collected via self-report questionnaires completed by 480 individuals with non-AATD COPD and 578 individuals with AATD-associated COPD under protocols with IRB approval. Multiple linear regression models were used to test whether individuals with non-AATD COPD differed from individuals with AATD-associated COPD with regard to depression, anxiety, dyspnea, and HRQL. All models adjusted for demographic and health characteristics. Individuals with AATD-associated COPD did not report more symptoms of depression or anxiety; however, they did report more dyspnea (B = 0.31, 95% CI = 0.16 to 0.47, p < 0.001) and impairment in HRQL (B = 4.75, 95% CI = 2.10 to 7.41, p < 0.001) than other individuals with COPD. Individuals with AATD-associated COPD were more likely to be a member of a couple (rather than single) and had a higher level of education when compared to individuals with non-AATD COPD. Resources available to persons with AATD-associated COPD, such as being in a serious relationship and having higher education, may offset the effect of age when considering symptoms of depression and anxiety in patients with COPD.
authors.affiliation: Department of Medicine, National Jewish Health, Denver, CO 80206, USA. holmk@njhealth.org
authors.forename: Kristen E
authors.initials: KE
authors.lastname: Holm
authors.forename: Soo
authors.initials: S
authors.lastname: Borson
authors.forename: Robert A
authors.initials: RA
authors.lastname: Sandhaus
authors.forename: Dee W
authors.initials: DW
authors.lastname: Ford
authors.forename: Charlie
authors.initials: C
authors.lastname: Strange
authors.forename: Russell P
authors.initials: RP
authors.lastname: Bowler
authors.forename: Barry J
authors.initials: BJ
authors.lastname: Make
authors.forename: Frederick S
authors.initials: FS
authors.lastname: Wamboldt
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D001007:Anxiety / Q000209:etiology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology*; D004417:Dyspnea / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D012907:Smoking / Q000009:adverse effects; D011795:Surveys and Questionnaires; D019896:alpha 1-Antitrypsin Deficiency / Q000150:complications* / Q000503:physiopathology / Q000523:psychology
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