title: Disability in moderate chronic obstructive pulmonary disease: prevalence, burden and assessment - results from a real-life study.
abstract: BACKGROUND
  The role of disability and its association with patient-reported outcomes in the nonsevere forms of chronic obstructive pulmonary disease (COPD) has never been explored.
  
  
  OBJECTIVE
  The aim of this study was to assess, in a cross-sectional real-life study, the prevalence and degree of disability in moderate COPD patients and to assess its association with health status, illness perception, risk of death and well-being.
  
  
  METHODS
  Moderate COPD outpatients attending scheduled visits were involved in a quantitative research program using a questionnaire-based data collection method.
  
  
  RESULTS
  Out of 694 patients, 17.4% were classified as disabled and 47.6% reported the loss of at least one relevant function of daily living. Disabled patients did not differ from nondisabled patients in terms of working status (p = 0.06), smoking habits (p = 0.134) and ongoing treatment (p = 0.823); however, the former showed a significantly higher disease burden as measured by illness perception, health status and well-being. The stepwise regression analysis showed that the modified Medical Research Council (mMRC) score was the most relevant factor related to COPD disability (F = 38.248; p = 0.001). Patient stratification was possible according to the forced expiratory volume in 1 s (FEV1) value and an mMRC score ≥2, which identified disabled patients, whereas the mMRC values were differently associated with the risk of disability.
  
  
  CONCLUSIONS
  A significant proportion of individuals with moderate COPD reported a limitation of daily life functions, with dyspnea being the most relevant factor inducing disability. Adding the evaluation of patient-reported outcomes to lung function assessment could facilitate the identification of disabled patients.
authors.affiliation: Allergy and Respiratory Diseases Clinic, DIMI, University of Genoa, IRCCS AOU San Martino-IST, Genova, Italy.
authors.forename: Fulvio
authors.initials: F
authors.lastname: Braido
authors.forename: Ilaria
authors.initials: I
authors.lastname: Baiardini
authors.forename: Nicola
authors.initials: N
authors.lastname: Scichilone
authors.forename: Claudio
authors.initials: C
authors.lastname: Sorino
authors.forename: Fabiano
authors.initials: F
authors.lastname: Di Marco
authors.forename: Angelo
authors.initials: A
authors.lastname: Corsico
authors.forename: Pierachille
authors.initials: P
authors.lastname: Santus
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Girbino
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Maria
authors.forename: Carlo
authors.initials: C
authors.lastname: Mereu
authors.forename: Eugenio
authors.initials: E
authors.lastname: Sabato
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Foschino Barbaro
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Cuttitta
authors.forename: Alberto
authors.initials: A
authors.lastname: Zolezzi
authors.forename: Caterina
authors.initials: C
authors.lastname: Bucca
authors.forename: Sara
authors.initials: S
authors.lastname: Balestracci
authors.forename: Giorgio Walter
authors.initials: GW
authors.lastname: Canonica
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology*