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Anxiety and depression are common comorbidities in chronic obstructive pulmonary disease (COPD) patients but are often under-diagnosed. We aimed to assess the suitability of the COPD Assessment Test (CAT) in screening anxiety and depression in patients with COPD. Stable COPD patients from a cross-sectional observational study were assessed by CAT. Anxiety and depression were identified using the Generalized Anxiety Disorder questionnaire (GAD-7) and Patient Health Questionnaire (PHQ-9), respectively. Logistic regression analysis and receiver operating characteristic curve analysis were used to identify factors associated with anxiety or depression and to calculate the predictive values. A total of 530 stable COPD patients were enrolled and of those, the proportions of anxiety and depression were 17.0% and 21.5%, respectively. The adjusted odds ratios of the CAT for the presence of anxiety and depression were 1.094 (95%CI: 1.057–1.131) and 1.143 (95%CI: 1.104–1.183), respectively. The CAT score had a significant predictive value for the presence of anxiety (AUC = 0.709) and depression (AUC = 0.791) with an optimum cutoff score of 15. However, the psychometric properties of CAT were undesirable, presenting high negative predictive value (NPV) but low positive predictive value (PPV). Among CAT items, analysis further showed that non-respiratory CAT components were superior to respiratory components in identifying both anxiety and depression. Our results indicated that CAT is more useful to exclude anxiety and depression rather than detect them. [ABSTRACT FROM AUTHOR]

We aimed to establish an easy-to-use screening questionnaire with risk factors and suspected symptoms of COPD for primary health care settings. Based on a nationwide epidemiological study of pulmonary health among adults in mainland China (China Pulmonary Health, CPH study) between 2012 and 2015, participants ≥40 years who completed the questionnaire and spirometry tests were recruited and randomly divided into development set and validation set by the ratio of 2:1. Parameters including sex, age, BMI, residence, education, smoking status, smoking pack-years, biomass exposure, parental history of respiratory diseases and daily respiratory symptoms were initially selected for the development of scoring system. Receiver operating characteristic (ROC) curve, area under curve (AUC), positive and negative predictive values were calculated in development set and validation set. After random split by 2:1 ratio, 22443 individuals were assigned to development set and 11221 to validation set. Ten variables were significantly associated with COPD independently in development set after a stepwise selection by multivariable logistic model and used to develop scoring system. The scoring system yielded good discrimination, as measured by AUC of 0.7737, and in the validation set, the AUC was 0.7711. When applying a cutoff point of ≥16, the sensitivity in development set was 0.69 (0.67 − 0.71); specificity 0.72 (0.71 − 0.73), PPV 0.25 (0.24 − 0.26) and NPV 0.94 (0.94 − 0.95). We developed and validated a comprehensive screening questionnaire, COPD-CPHS, with good discrimination. The score system still needs to be validated by large cohort in the future. Supplemental data for this article is available online at https://doi.org/10.1080/15412555.2022.2042504. [ABSTRACT FROM AUTHOR]

Background and objective It is not known whether patients with chronic obstructive pulmonary disease ( COPD) have a different exercise capacity with ( CB+) or without accompanying chronic bronchitis ( CB−). Methods We conducted spirometry, a 6-min walk distance test and cardiopulmonary exercise test in 50 age-matched healthy control subjects, 45 COPD patients without CB ( CB−) and 37 COPD patients with CB ( CB+). A multiple regression model was established to identify factors independently associated with peak oxygen consumption ( [ABSTRACT FROM AUTHOR]

Studies on the association of greenness with respiratory health are scarce in developing countries, and previous studies in China have focused on only one or two indicators of lung function. The study aims to evaluate the associations of residential greenness with full-spectrum lung function indicators and prevalence of chronic obstructive pulmonary disease (COPD). This nationwide cross-sectional survey included 50,991 participants from the China Pulmonary Health study. Lung function indicators included four categories: indicators of obstructive ventilatory dysfunction (FEV 1 , FVC and FEV 1 /FVC); an indicator of large-airway dysfunction (PEF); indicators of small-airway dysfunction (FEF 25–75% and FEV 3 /FEV 6); and other indicators. Residential greenness was assessed by the Normalized Difference Vegetation Index (NDVI). Multivariable linear regression models and logistic regression models were used to analyze associations of greenness with lung function and COPD prevalence. Within the 500 m buffer, an interquartile range (IQR) increase in NDVI was associated with higher FEV 1 (24.76 mL), FVC (16.52 mL), FEV 1 /FVC (0.38), FEF 50% (56.34 mL/s), FEF 75% (33.43 mL/s), FEF 25–75% (60.73 mL/s), FEV 3 (18.59 mL), and FEV 6 (21.85 mL). However, NDVI was associated with lower PEF. In addition, NDVI was significantly associated with 10% lower odds of COPD. The stratified analyses found that the associations were only significant in middle-young people, females, and nonsmokers. The associations were influenced by geographic regions. Residential greenness was associated with better lung function and lower odds of COPD in China. These findings provide a scientific basis for healthy community planning. • The analysis included 50,991 participants from the China Pulmonary Health study. • Greenness was associated with better lung function. • Greenness was associated with lower odds of COPD. • The associations were modified by age, sex, geographic region, and smoking history. [ABSTRACT FROM AUTHOR]