What influences change in health status in COPD in a seven year follow-up?

Background: Health status is important in assessment of COPD. Our study examined factors influencing change in health status in COPD. Methods: In 2005; 970 randomly selected primary and secondary care patients with a COPD diagnosis completed patient questionnaires including clinical characteristics and health status assessed by the Clinical COPD Questionnaire (CCQ). In 2012; 413 of 501 still available patients from 2005 completed the CCQ. Linear regression used mean total CCQ in 2012 as dependent variable, with adjustment for baseline mean total CCQ, sex, age, educational level, BMI, smoking status, heart disease, diabetes, depression, number of exacerbations recent year, mMRC, and in a subgroup; COPD stage (n=237). Results: Health status worsened from mean total CCQ (+SD) 2.03 (+1.26) in 2005 to 2.16 (+1.37) in 2012 (p= 0.011). Uni-linear regression with adjustment for baseline CCQ showed significant associations with lower health status in 2012 for higher age, lower education, higher mMRC and higher COPD stage, and with improved health status for BMI 26-30 kg/m2. In multi-linear regression, higher mMRC was associated with lower health status (adjusted regression coefficient (95%CI) 0.26 (0.16 to 0.36), p <0.0001), and BMI 26-30 kg/m2 with improved health status (-0.32 (-0.56 to -0.09), p= 0.008). Conclusion: Higher mMRC is associated with worsened health status and overweight with improved health status in COPD. Strategies for decreasing dyspnoea and gaining weight in under and normal weight patients with COPD are of clinical importance.