Anxiety is associated with diminished exercise performance and quality of life in severe emphysema

A cross-sectional study

Nicholas D. Giardino, Jeffrey L. Curtis, Adin Cristian Andrei, Vincent S. Fan, Joshua O. Benditt, Mark Lyubkin, Keith Naunheim, Gerard Criner, Barry Make, Robert A Wise, Susan K. Murray, Alfred P. Fishman, Frank C. Sciurba, Israel Liberzon, Fernando J. Martinez

Research output: Contribution to journalArticle

Abstract

Background: Anxiety in patients with chronic obstructive pulmonary disease (COPD) is associated with self-reported disability. The purpose of this study is to determine whether there is an association between anxiety and functional measures, quality of life and dyspnea.Methods: Data from 1828 patients with moderate to severe emphysema enrolled in the National Emphysema Treatment Trial (NETT), collected prior to rehabilitation and randomization, were used in linear regression models to test the association between anxiety symptoms, measured by the Spielberger State Trait Anxiety Inventory (STAI) and: (a) six-minute walk distance test (6 MWD), (b) cycle ergometry peak workload, (c) St. Georges Respiratory Questionnaire (SRGQ), and (d) UCSD Shortness of Breath Questionnaire (SOBQ), after controlling for potential confounders including age, gender, FEV1 (% predicted), DLCO (% predicted), and the Beck Depression Inventory (BDI).Results: Anxiety was significantly associated with worse functional capacity [6 MWD (B = -0.944, p <.001), ergometry peak workload (B = -.087, p = .04)], quality of life (B = .172, p <.001) and shortness of breath (B = .180, p <.001). Regression coefficients show that a 10 point increase in anxiety score is associated with a mean decrease in 6 MWD of 9 meters, a 1 Watt decrease in peak exercise workload, and an increase of almost 2 points on both the SGRQ and SOBQ.Conclusion: In clinically stable patients with moderate to severe emphysema, anxiety is associated with worse exercise performance, quality of life and shortness of breath, after accounting for the influence of demographic and physiologic factors known to affect these outcomes.Trail Registration: ClinicalTrials.gov NCT00000606.

Original languageEnglish (US)
Article number29
JournalRespiratory Research
Volume11
DOIs
StatePublished - Mar 9 2010

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Emphysema
Anxiety
Cross-Sectional Studies
Quality of Life
Exercise
Dyspnea
Workload
Ergometry
Linear Models
Equipment and Supplies
Random Allocation
Chronic Obstructive Pulmonary Disease
Rehabilitation
Demography
Depression
Surveys and Questionnaires

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Giardino, N. D., Curtis, J. L., Andrei, A. C., Fan, V. S., Benditt, J. O., Lyubkin, M., ... Martinez, F. J. (2010). Anxiety is associated with diminished exercise performance and quality of life in severe emphysema: A cross-sectional study. Respiratory Research, 11, [29]. https://doi.org/10.1186/1465-9921-11-29

Anxiety is associated with diminished exercise performance and quality of life in severe emphysema : A cross-sectional study. / Giardino, Nicholas D.; Curtis, Jeffrey L.; Andrei, Adin Cristian; Fan, Vincent S.; Benditt, Joshua O.; Lyubkin, Mark; Naunheim, Keith; Criner, Gerard; Make, Barry; Wise, Robert A; Murray, Susan K.; Fishman, Alfred P.; Sciurba, Frank C.; Liberzon, Israel; Martinez, Fernando J.

In: Respiratory Research, Vol. 11, 29, 09.03.2010.

Research output: Contribution to journalArticle

Giardino, ND, Curtis, JL, Andrei, AC, Fan, VS, Benditt, JO, Lyubkin, M, Naunheim, K, Criner, G, Make, B, Wise, RA, Murray, SK, Fishman, AP, Sciurba, FC, Liberzon, I & Martinez, FJ 2010, 'Anxiety is associated with diminished exercise performance and quality of life in severe emphysema: A cross-sectional study', Respiratory Research, vol. 11, 29. https://doi.org/10.1186/1465-9921-11-29
Giardino, Nicholas D. ; Curtis, Jeffrey L. ; Andrei, Adin Cristian ; Fan, Vincent S. ; Benditt, Joshua O. ; Lyubkin, Mark ; Naunheim, Keith ; Criner, Gerard ; Make, Barry ; Wise, Robert A ; Murray, Susan K. ; Fishman, Alfred P. ; Sciurba, Frank C. ; Liberzon, Israel ; Martinez, Fernando J. / Anxiety is associated with diminished exercise performance and quality of life in severe emphysema : A cross-sectional study. In: Respiratory Research. 2010 ; Vol. 11.
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abstract = "Background: Anxiety in patients with chronic obstructive pulmonary disease (COPD) is associated with self-reported disability. The purpose of this study is to determine whether there is an association between anxiety and functional measures, quality of life and dyspnea.Methods: Data from 1828 patients with moderate to severe emphysema enrolled in the National Emphysema Treatment Trial (NETT), collected prior to rehabilitation and randomization, were used in linear regression models to test the association between anxiety symptoms, measured by the Spielberger State Trait Anxiety Inventory (STAI) and: (a) six-minute walk distance test (6 MWD), (b) cycle ergometry peak workload, (c) St. Georges Respiratory Questionnaire (SRGQ), and (d) UCSD Shortness of Breath Questionnaire (SOBQ), after controlling for potential confounders including age, gender, FEV1 ({\%} predicted), DLCO ({\%} predicted), and the Beck Depression Inventory (BDI).Results: Anxiety was significantly associated with worse functional capacity [6 MWD (B = -0.944, p <.001), ergometry peak workload (B = -.087, p = .04)], quality of life (B = .172, p <.001) and shortness of breath (B = .180, p <.001). Regression coefficients show that a 10 point increase in anxiety score is associated with a mean decrease in 6 MWD of 9 meters, a 1 Watt decrease in peak exercise workload, and an increase of almost 2 points on both the SGRQ and SOBQ.Conclusion: In clinically stable patients with moderate to severe emphysema, anxiety is associated with worse exercise performance, quality of life and shortness of breath, after accounting for the influence of demographic and physiologic factors known to affect these outcomes.Trail Registration: ClinicalTrials.gov NCT00000606.",
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T2 - A cross-sectional study

AU - Giardino, Nicholas D.

AU - Curtis, Jeffrey L.

AU - Andrei, Adin Cristian

AU - Fan, Vincent S.

AU - Benditt, Joshua O.

AU - Lyubkin, Mark

AU - Naunheim, Keith

AU - Criner, Gerard

AU - Make, Barry

AU - Wise, Robert A

AU - Murray, Susan K.

AU - Fishman, Alfred P.

AU - Sciurba, Frank C.

AU - Liberzon, Israel

AU - Martinez, Fernando J.

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N2 - Background: Anxiety in patients with chronic obstructive pulmonary disease (COPD) is associated with self-reported disability. The purpose of this study is to determine whether there is an association between anxiety and functional measures, quality of life and dyspnea.Methods: Data from 1828 patients with moderate to severe emphysema enrolled in the National Emphysema Treatment Trial (NETT), collected prior to rehabilitation and randomization, were used in linear regression models to test the association between anxiety symptoms, measured by the Spielberger State Trait Anxiety Inventory (STAI) and: (a) six-minute walk distance test (6 MWD), (b) cycle ergometry peak workload, (c) St. Georges Respiratory Questionnaire (SRGQ), and (d) UCSD Shortness of Breath Questionnaire (SOBQ), after controlling for potential confounders including age, gender, FEV1 (% predicted), DLCO (% predicted), and the Beck Depression Inventory (BDI).Results: Anxiety was significantly associated with worse functional capacity [6 MWD (B = -0.944, p <.001), ergometry peak workload (B = -.087, p = .04)], quality of life (B = .172, p <.001) and shortness of breath (B = .180, p <.001). Regression coefficients show that a 10 point increase in anxiety score is associated with a mean decrease in 6 MWD of 9 meters, a 1 Watt decrease in peak exercise workload, and an increase of almost 2 points on both the SGRQ and SOBQ.Conclusion: In clinically stable patients with moderate to severe emphysema, anxiety is associated with worse exercise performance, quality of life and shortness of breath, after accounting for the influence of demographic and physiologic factors known to affect these outcomes.Trail Registration: ClinicalTrials.gov NCT00000606.

AB - Background: Anxiety in patients with chronic obstructive pulmonary disease (COPD) is associated with self-reported disability. The purpose of this study is to determine whether there is an association between anxiety and functional measures, quality of life and dyspnea.Methods: Data from 1828 patients with moderate to severe emphysema enrolled in the National Emphysema Treatment Trial (NETT), collected prior to rehabilitation and randomization, were used in linear regression models to test the association between anxiety symptoms, measured by the Spielberger State Trait Anxiety Inventory (STAI) and: (a) six-minute walk distance test (6 MWD), (b) cycle ergometry peak workload, (c) St. Georges Respiratory Questionnaire (SRGQ), and (d) UCSD Shortness of Breath Questionnaire (SOBQ), after controlling for potential confounders including age, gender, FEV1 (% predicted), DLCO (% predicted), and the Beck Depression Inventory (BDI).Results: Anxiety was significantly associated with worse functional capacity [6 MWD (B = -0.944, p <.001), ergometry peak workload (B = -.087, p = .04)], quality of life (B = .172, p <.001) and shortness of breath (B = .180, p <.001). Regression coefficients show that a 10 point increase in anxiety score is associated with a mean decrease in 6 MWD of 9 meters, a 1 Watt decrease in peak exercise workload, and an increase of almost 2 points on both the SGRQ and SOBQ.Conclusion: In clinically stable patients with moderate to severe emphysema, anxiety is associated with worse exercise performance, quality of life and shortness of breath, after accounting for the influence of demographic and physiologic factors known to affect these outcomes.Trail Registration: ClinicalTrials.gov NCT00000606.

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