IMPACT OF OBSTRUCTIVE AIRWAYS DISEASE ON QUALITY-OF-LIFE IN OLDER ADULTS

Background - Obstructive airways disease adversely affects quality of life, although relationships between quality of life and lung function have been shown to be weak. The relationships between the results of a quality of life questionnaire, spirometric tests, and methacholine b ronchial challenge were investigated in a population sample of middle aged and elderly people. Methods - A random population sample of the w hite population of Central Manchester, UK were contacted by post. Resp ondents were invited to undergo bronchial challenge with methacholine (Newcastle dosimeter method) and to complete the St George's Respirato ry Questionnaire. This self-completed questionnaire-quantifies quality of life as three component scores, with higher scores indicating grea ter impairment of quality of life. Results - Two hundred and twenty se ven subjects aged 45-86 years completed the St George's Questionnaire and performed spirometric tests; 190 completed the methacholine challe nge. All quality of life scores were higher in subjects with a forced expiratory volume in one second (FEV(1))/forced vital capacity (FVC) o f <65%, indicating impaired quality of life in subjects with airways o bstruction. There was no relationship between quality of life and age. Multiple regression analysis showed independent relationships between quality of life scores and both baseline FEV(1) and bronchial respons iveness. However, the amount of variation in quality of Life attributa ble to variation in FEV(1) or bronchial responsiveness was less than 1 0%. Subgroup analysis indicated that the quality of life score was ind ependently associated with bronchial responsiveness and not-FEV(1), in subjects aged <65 years, but with baseline FEV(1) and not bronchial r esponsiveness in older subjects. Conclusions - Obstructive airways dis ease significantly impairs quality of life in adults. The reduction in quality of life in these patients is related to both baseline pulmona ry function and non-specific bronchial responsiveness. The impact of a irways obstruction on quality of life does not decrease with advancing age.