DEPRESSION IN ELDERLY OUTPATIENTS WITH DISABLING CHRONIC OBSTRUCTIVE PULMONARY-DISEASE

Introduction: depression is common in both young adults and elderly pe ople with chronic obstructive pulmonary disease (COPD), Methods: we co mpared the prevalence of depressive symptomatology in elderly outpatie nts with stable disabling COPD with that in healthy controls and age-m atched patients with other disabilities, and also assessed the relatio n between degree of disability, quality of life and depressive symptom s. The subjects were 96 older people with COPD [56 men; aged 70-93 (me an 78) years], 55 normal controls [23 men; aged 70-90 (mean 78) years] and 53 disabled controls [27 men; aged 70-92 (mean 78) years]. Exclus ion criteria were acute respiratory exacerbation or use of oral steroi ds in the last 6 weeks, known previous psychiatric disorder and acute or chronic confusion. Results: mean land SD) values for 1-s forced exp iratory volume (FEV1) were 51 (20)% in COPD subjects, 107 (24)% in nor mal controls and 82 (13)% in disabled controls. Forty-four subjects wi th COPD (46%), six normal controls (11%) and 14 disabled controls (26% ) scored in the 'caseness' range for depressive ideation on the Brief Assessment Schedule Depression Cards (BASDEC) screening questionnaire. A multiple regression analysis was performed for the COPD group to id entify factors predictive of BASDEC score. Predictive variables were t otal quality of life score [P<0.0001], Chronic Respiratory Questionnai re and level of activities of daily living (Nottingham extended activi ties of daily living scale) [P = 0.001]. Spirometry results and exerci se tolerance (6-min walk distance) did not help predict BASDEC score ( R-2 = 0.50). Conclusions: depressive symptoms are common in elderly pa tients with COPD; prevalence and/or severity of depressive symptoms ma y be greater in those who are most disabled.