title: Chronic obstructive pulmonary disease and asthma-patient characteristics and health impairment.
abstract: Abstract Background: Persons with chronic obstructive pulmonary disease (COPD) and/or asthma have great risk for morbidity. There has been sparse state-specific surveillance data to estimate the impact of COPD or COPD with concomitant asthma (overlap syndrome) on health-related impairment.
  
  
  METHODS
  The North Carolina (NC) Behavioral Risk Factor Surveillance System (BRFSS) was used to assess relationships between COPD and asthma with health impairment indicators. Five categories [COPD, current asthma, former asthma, overlap syndrome, and neither] were defined for 24,073 respondents. Associations of these categories with health impairments (physical or mental disability, use of special equipment, mental or physical distress) and with co-morbidities (diabetes, coronary heart disease, stroke, arthritis, and high blood pressure) were assessed.
  
  
  RESULTS
  Fifteen percent of NC adults reported a COPD and/or asthma history. The overall age-adjusted prevalence of any self-reported COPD and current asthma were 5.6% and 7.6%, respectively; 2.4% reported both. In multivariable analyses, adults with overlap syndrome, current asthma only, and COPD only were twice as likely as those with neither disease to report health impairments (p < 0.05). Compared to those with neither disease, adults with overlap syndrome and COPD were more likely to have co-morbidities (p < 0.05). The prevalence of the five co-morbid conditions was highest in overlap syndrome; comparisons with the other groups were significant (p < 0.05) only for diabetes, stroke, and arthritis.
  
  
  CONCLUSIONS
  The BRFSS demonstrates different levels of health impairment among persons with COPD, asthma, overlap syndrome, and those with neither disease. Persons reporting overlap syndrome had the most impairment and highest prevalence of co-morbidities.
authors.affiliation: 1Campbell University College of Pharmacy and Health Sciences and Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University School of Medicine , Durham, NC , USA.
authors.forename: Roy A
authors.initials: RA
authors.lastname: Pleasants
authors.forename: Jill A
authors.initials: JA
authors.lastname: Ohar
authors.forename: Janet B
authors.initials: JB
authors.lastname: Croft
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.forename: Monica
authors.initials: M
authors.lastname: Kraft
authors.forename: David M
authors.initials: DM
authors.lastname: Mannino
authors.forename: James F
authors.initials: JF
authors.lastname: Donohue
authors.forename: Harry L
authors.initials: HL
authors.lastname: Herrick
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D001168:Arthritis / Q000453:epidemiology; D001249:Asthma / Q000453:epidemiology* / Q000523:psychology; D040343:Behavioral Risk Factor Surveillance System; D015897:Comorbidity; D003327:Coronary Disease / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000523:psychology; D012656:Self-Help Devices / Q000706:statistics & numerical data; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D020521:Stroke / Q000453:epidemiology; D055815:Young Adult
keywords: Behavioral Risk factor Surveillance System; asthma; chronic obstructive pulmonary disease; health impairment; overlap syndrome