title: Quality of life in older patients with chronic obstructive pulmonary disease (COPD) in Hong Kong: a case-control study.
abstract: OBJECTIVE
  To date, there have been few studies examining quality of life (QOL) in older patients with chronic obstructive pulmonary disease (COPD) in China. The aim of the study was to assess QOL in Chinese older patients with COPD and explore its demographic and clinical correlates.
  
  
  METHODS
  Case-control study of 142 outpatients with COPD and 218 matched control subjects without COPD. COPD patients were recruited from a prospective study sample hospitalized in Hong Kong for acute COPD exacerbation (≥ 2 major COPD symptoms or > 1 major + minor COPD symptoms for ≥ 2 consecutive days). Controls were recruited from social centers in Hong Kong. Activity of daily living was assessed with the Instrumental Activities of Daily Living Scale (IADL), life events were evaluated with the Life Event Scale, depressive disorders were diagnosed using the Geriatric Depression Scale (GDS), and QOL was measured using the Medical Outcomes Study Short Form-12 (SF-12) and St. George's Respiratory Questionnaire (SGRQ).
  
  
  RESULTS
  Compared to controls, patients had significantly lower scores in the physical (PCS score), but not in the mental (MCS score) QOL domain. Multivariate analyses showed that more hospitalizations in the past year significantly contributed to higher PCS score (p = .03), while higher GDS total score contributed to lower MCS score (p = .003). Severe and very severe COPD, more physical illnesses, and higher IADL total score each independently contributed to higher SGRQ total score, explaining 40.0% of the variance (p < .001).
  
  
  CONCLUSIONS
  Our results suggest that therapeutic and psychosocial interventions alleviating depressive symptoms, severe COPD, comorbidities, and improving IADL in Chinese patients with COPD are likely of considerable benefit for improving QOL in patients with COPD.
authors.affiliation: Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China; Faculty of Health Sciences, University of Macau, Macao SAR, China.
authors.forename: Yu-Tao
authors.initials: YT
authors.lastname: Xiang
authors.forename: Tak-Shun
authors.initials: TS
authors.lastname: Wong
authors.forename: Joshua
authors.initials: J
authors.lastname: Tsoh
authors.forename: Gabor S
authors.initials: GS
authors.lastname: Ungvari
authors.forename: Christoph U
authors.initials: CU
authors.lastname: Correll
authors.forename: Jitender
authors.initials: J
authors.lastname: Sareen
authors.forename: Kirsten
authors.initials: K
authors.lastname: Penner-Goeke
authors.forename: Fanny W S
authors.initials: FW
authors.lastname: Ko
authors.forename: David S C
authors.initials: DS
authors.lastname: Hui
authors.forename: Helen F K
authors.initials: HF
authors.lastname: Chiu
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006305:Health Status Indicators; D006723:Hong Kong / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: Chronic obstructive pulmonary disease; depression; elderly; outpatient; quality of life