Abstract
Background: the COPD Assessment Test (CAT) is a disease-specific tool to assess health status and should not be influenced by comorbidities. Aims: to evaluate the CAT score according to the presence of comorbidities and its interaction with smoking and COPD. Method: this is a cross-sectional population-based study consisting of visits to households randomly selected. The subjects answered the CAT, a questionnaire with clinical data and performed spirometry. Depression symptoms were assessed by the Hospital Anxiety and Depression Scale. The subjects reported if they have medical diagnosis of heart diseases, rhinitis, gastritis/reflux or asthma. A two-way ANOVA and the Bonferroni post hoc tests were used to evaluate the interactions between groups (non, former or current smokers and COPD) and comorbidities. Statistical significance was p<0.05. Results: 1057 subjects (58±11 years, FEV1 92.2±20.9% of predicted, CAT 6.9±7.0) were included. It was observed significant interaction between groups and depression symptoms (F=10.1), obesity (F=3.6), and gastritis/reflux (F=2.8) on the CAT score (p<0.05). The CAT score was higher in subjects with depression symptoms compared to those without, regardless the group (p<0.01). Patients with COPD and depression symptoms had a CAT score of 19.2 (95%CI 16.3-22.1) compared to 8.5 (95%CI 7.0-9.9) in patients with COPD without depression symptoms (p<0.01). It was not observed significant interaction between groups and rhinitis (F=0.6), heart diseases (F=1.3) and asthma (F=0.1) (p>0.05). Conclusions: the presence of depression symptoms increased the CAT score in non, former and current smokers and in COPD patients. Obesity and gastritis/reflux also increased the CAT score.
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