title: Age-Related Differences in Health-Related Quality of Life in COPD: An Analysis of the COPDGene and SPIROMICS Cohorts.
abstract: OBJECTIVE
  Younger persons with COPD report worse health-related quality of life (HRQL) than do older individuals. The factors explaining these differences remain unclear. The objective of this article was to explore factors associated with age-related differences in HRQL in COPD.
  
  
  METHODS
  Cross-sectional analysis of participants with COPD, any Global Initiative for Chronic Obstructive Lung Disease grade of airflow limitation, and ≥ 50 years old in two cohorts: the Genetic Epidemiology of COPD (COPDGene) study and the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS). We compared St. George's Respiratory Questionnaire (SGRQ) scores by age group: middle-aged (age, 50-64) vs older (age, 65-80) adults. We used multivariate linear modeling to test associations of age with HRQL, adjusting for demographic and clinical characteristics and comorbidities.
  
  
  RESULTS
  Among 4,097 participants in the COPDGene study (2,170 middle-aged and 1,927 older adults) SGRQ total scores were higher (worse) among middle-aged (mean difference, -4.2 points; 95% CI, -5.7 to -2.6; P < .001) than older adults. Age had a statistically significant interaction with dyspnea (P < .001). Greater dyspnea severity (modified Medical Research Council ≥ 2, compared with 0-1) had a stronger association with SGRQ score among middle-aged (β, 24.6; 95% CI, 23.2-25.9) than older-adult (β, 21.0; 95% CI, 19.6-22.3) participants. In analyses using SGRQ as outcome in 1,522 participants in SPIROMICS (598 middle-aged and 924 older adults), we found similar associations, confirming that for the same severity of dyspnea there is a stronger association with HRQL among younger individuals.
  
  
  CONCLUSIONS
  Age-related differences in HRQL may be explained by a higher impact of dyspnea among younger subjects with COPD.
  
  
  BACKGROUND
  ClinicalTrials.gov; No.: NCT00608764 and No.: NCT01969344; URL: www.clinicaltrials.gov.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI. Electronic address: carlosma@umich.edu.
authors.forename: Carlos H
authors.initials: CH
authors.lastname: Martinez
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
authors.forename: Alejandro A
authors.initials: AA
authors.lastname: Diaz
authors.affiliation: Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, TX.
authors.forename: Amit D
authors.initials: AD
authors.lastname: Parulekar
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of Nebraska, Omaha, NE.
authors.forename: Stephen I
authors.initials: SI
authors.lastname: Rennard
authors.affiliation: University of Utah, Salt Lake City, UT.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Kanner
authors.affiliation: Johns Hopkins University, Baltimore, MD.
authors.forename: Nadia N
authors.initials: NN
authors.lastname: Hansel
authors.affiliation: University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: David
authors.initials: D
authors.lastname: Couper
authors.affiliation: National Jewish Health, Denver, CO; School of Public Health, University of Colorado, Aurora, CO.
authors.forename: Kristen E
authors.initials: KE
authors.lastname: Holm
authors.affiliation: Department of Psychiatry, University of Iowa, Iowa City, IA.
authors.forename: Karin F
authors.initials: KF
authors.lastname: Hoth
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI; VA Ann Arbor Healthcare System, Ann Arbor, MI.
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Curtis
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI.
authors.forename: Fernando J
authors.initials: FJ
authors.lastname: Martinez
authors.affiliation: Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, TX.
authors.forename: Nicola A
authors.initials: NA
authors.lastname: Hanania
authors.affiliation: National Jewish Health, Denver, CO; University of Colorado, Denver, CO.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Regan
authors.affiliation: University of Utah, Salt Lake City, UT; VA Salt Lake City, Salt Lake City, UT.
authors.forename: Robert
authors.initials: R
authors.lastname: Paine
authors.affiliation: Department of Family Medicine, University of Michigan, Ann Arbor, MI; VA Ann Arbor Healthcare System, Ann Arbor, MI.
authors.forename: Christine T
authors.initials: CT
authors.lastname: Cigolle
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI.
authors.forename: MeiLan K
authors.initials: MK
authors.lastname: Han
mesh_terms: D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004417:Dyspnea / Q000503:physiopathology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D011788:Quality of Life
keywords: COPD; aging; dyspnea; geriatrics; health status; obstructive lung disease; quality of life
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