title: Changes in physical activity and all-cause mortality in COPD.
abstract: Little is known about changes in physical activity in subjects with chronic obstructive pulmonary disease (COPD) and its impact on mortality. Therefore, we aimed to study changes in physical activity in subjects with and without COPD and the impact of physical activity on mortality risk. Subjects from the Copenhagen City Heart Study with at least two consecutive examinations were selected. Each examination included a self-administered questionnaire and clinical examination. 1270 COPD subjects and 8734 subjects without COPD (forced expiratory volume in 1 s 67±18 and 91±15% predicted, respectively) were included. COPD subjects with moderate or high baseline physical activity who reported low physical activity level at follow-up had the highest hazard ratios of mortality (1.73 and 2.35, respectively; both p<0.001). In COPD subjects with low baseline physical activity, no differences were found in survival between unchanged or increased physical activity at follow-up. In addition, subjects without COPD with low physical activity at follow-up had the highest hazard ratio of mortality, irrespective of baseline physical activity level (p≤0.05). A decline to low physical activity at follow-up was associated with an increased mortality risk in subjects with and without COPD. These observational data suggest that it is important to assess and encourage physical activity in the earliest stages of COPD in order to maintain a physical activity level that is as high as possible, as this is associated with better prognosis.
authors: Dept of Research and Education, CIRO+, Horn, The Netherlands Dept of Physiotherapy, CIRO+, Horn, The Netherlands Anoukvaes@ciro-horn.nl.
authors: Anouk W
authors: AW
authors: Vaes
authors: Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra (UPF), Barcelona, Spain.
authors: Judith
authors: J
authors: Garcia-Aymerich
authors: Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen, Denmark.
authors: Jacob L
authors: JL
authors: Marott
authors: Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
authors: Marta
authors: M
authors: Benet
authors: Dept of Research and Education, CIRO+, Horn, The Netherlands.
authors: Miriam T J
authors: MT
authors: Groenen
authors: Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen, Denmark.
authors: Peter
authors: P
authors: Schnohr
authors: Dept of Research and Education, CIRO+, Horn, The Netherlands.
authors: Frits M E
authors: FM
authors: Franssen
authors: Dept of Respiratory Medicine, Odense University Hospital, Odense, Denmark Respiratory and Allergy Research Group, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
authors: Jørgen
authors: J
authors: Vestbo
authors: Dept of Research and Education, CIRO+, Horn, The Netherlands Dept of Respiratory Medicine, MUMC+, Maastricht, The Netherlands.
authors: Emiel F M
authors: EF
authors: Wouters
authors: Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen, Denmark Dept of Cardiology and Respiratory Medicine, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark Dept of Public Health, University of Copenhagen, Copenhagen, Denmark Joint senior authors.
authors: Peter
authors: P
authors: Lange
authors: Dept of Research and Education, CIRO+, Horn, The Netherlands REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium Joint senior authors.
authors: Martijn A
authors: MA
authors: Spruit
mesh_terms: D000328:Adult; D000368:Aged; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality* / Q000503:physiopathology*; D012129:Respiratory Function Tests; D012307:Risk Factors; D013147:Spirometry; D011795:Surveys and Questionnaires