Abstract
Introduction:Depression is common in COPD patients. Around 40% are affected by severe depressive symptoms or clinical depression. In the elderly COPD patients, dyspnea seems to be different from disease severity. Aims:We investigated whether depression is correlated with dyspnea. Methods:Outpatients over the age of 65 (85 persons) with stable COPD were enrolled. We used CAT score to assess the level of dyspnea. Depression was assessed as measure Hamilton Rating Scale for Depression(HDRS), Patient Health Questionnaire-9(PHQ-9), Patient Health Questionnaire-2(PHQ-2), and Geriatric Depression Scale-Short Form-Korea(GDS-SF-K).Results:Prevalence of depression were 24.7% (21, HDRS), 31.0% (27, PHQ-9), 8%(7, PHQ-2) and 23.0%(20, GDS-SF-K). When classified according to the GOLD criteria, HDRS of mild(28), moderate(33), severe(17), and very severe COPD patients (4) were 4.92±3.80, 3.70±3.00, 5.94±4.22, and 10.00±10.92, independently.(p=0.027). HDRS-Depression group (mild 7, moderate 4, severe 7, very severe 2) was not significantly difference compared to HDRS-normal group in FEV1(1.53±0.32L vs 1.62±0.29L, p>0.05), But CAT score was significantly higher(32.4±10.2vs24±5.3, p=0.045). At 1-year of follow-up, a reduced FEV1(ml) in the two groups showed no significant difference(8.4±8.2 vs 7.7±7.4, p>0.05), but CAT score was higher in the depression group (33.6±11.4vs22.4±6.7, p=0.014). The frequency of acute exacerbation of depression group compared to normal group showed a tendency to increase(1.8±1.1vs1.6±0.5, p>0.05).Conclusions:In the elderly COPD patients, more severe reduction in lung function have severe depression and depression worse dyspnea.
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