Differences in adjustment between individuals with alpha-1 antitrypsin deficiency (AATD)-associated COPD and Non-AATD COPD

Kristen E. Holm, Soo Borson, Robert A. Sandhaus, Dee W. Ford, Charlie Strange, Russell P. Bowler, Barry J. Make, Frederick S. Wamboldt

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Smokers who have severe alpha-1 antitrypsin deficiency (AATD) are at risk for developing COPD earlier in life than smokers without AATD, and are likely to experience challenges adjusting to their illness because they are in a highly productive life stage when they are diagnosed with COPD. This study examined whether individuals with AATD-associated COPD differ from individuals with non-AATD COPD with regard to depression, anxiety, dyspnea, and health-related quality of life (HRQL). Cross-sectional data were collected via self-report questionnaires completed by 480 individuals with non-AATD COPD and 578 individuals with AATD-associated COPD under protocols with IRB approval. Multiple linear regression models were used to test whether individuals with non-AATD COPD differed from individuals with AATD-associated COPD with regard to depression, anxiety, dyspnea, and HRQL. All models adjusted for demographic and health characteristics. Individuals with AATD-associated COPD did not report more symptoms of depression or anxiety; however, they did report more dyspnea (B = 0.31, 95% CI = 0.16 to 0.47, p < 0.001) and impairment in HRQL (B = 4.75, 95% CI = 2.10 to 7.41, p < 0.001) than other individuals with COPD. Individuals with AATD-associated COPD were more likely to be a member of a couple (rather than single) and had a higher level of education when compared to individuals with non-AATD COPD. Resources available to persons with AATD-associated COPD, such as being in a serious relationship and having higher education, may offset the effect of age when considering symptoms of depression and anxiety in patients with COPD.

Original languageEnglish (US)
Pages (from-to)226-234
Number of pages9
JournalCOPD: Journal of Chronic Obstructive Pulmonary Disease
Volume10
Issue number2
DOIs
StatePublished - Apr 2013

Bibliographical note

Funding Information:
This work was supported by the National Institutes of Health (grantsF32 HL083687, K23 HL091049) and a Postdoctoral Research Fellowship Grant from the Alpha-1 Foundation. Supported in part by the Colorado Clinical Translational Science Award grant 1 UL1 RR025780 from NCRR/NIH. Dr. Holm has received research grants from the National Institutes of Health and the Alpha-1 Foundation. Dr. Borson has received funding for COPD research from the Veterans Affairs Medical Research Service and from NHLBI (5R01HL093146-02). Dr. Sandhaus is the medical director of two not-for-profit organizations that support research and provide health management for the Alpha-1 Antitrypsin Deficiency community. Dr. Ford has received research grants from the National Institutes of Health and Department of Defense. Dr. Strange has research grants, consultancies, and speakers bureau disclosures related to COPD, Alpha-1 Antitrypsin Deficiency, and other pulmonary diseases that do not influence the content of this manuscript. Dr. Bowler has NIH and pharmaceutical research grants and speakers bureau disclosures related to COPD that do not influence the content of this manuscript. Dr. Make has received funding from governmental and pharmaceutical firms related to COPD. Dr. Wamboldt has received grant support from governmental and private foundations and his wife has received funding from pharmaceutical firms unrelated to the topic of this report. Drs. Holm, Sandhaus, Bowler, Make, and Wam-boldt are employed by National Jewish Health. Dr. Bor-son is employed by the University of Washington School of Medicine. Drs. Ford and Strange are employed by the Medical University of South Carolina.

Keywords

  • Alpha-1 Antitrypsin Deficiency
  • Anxiety
  • Depression
  • Dyspnea
  • Health Status
  • Psychological Adjustment.

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