PERCEPTION OF FATIGUE AND QUALITY-OF-LIFE IN PATIENTS WITH COPD

Introduction: Although dyspnea is considered the primary activity-limi ting symptom in patients with COPD, other symptoms, such as fatigue, a re frequently reported, The purpose of this study was to determine the relationship between fatigue and pulmonary function, exercise toleran ce, depression, and qualify of life in patients with COPD. Methods: Fo rty-one patients (age 62 +/- 8 years; FEV, = 1.08 +/- 0.55 L; FEV1 per cent predicted = 35.8 +/- 17%) fi om two sites participated in the stu dy. Spirometric measures of pulmonary function were carried out in eac h patient. The Multidimensional Fatigue Inventory was used to measure five subscales of fatigue: general, physical and mental fatigue, reduc tion in activity, and reduction in motivation, The SI. George Respirat ory Questionnaire, used to measure quality of life, has three subscale dimensions (symptom, activity, and impact), as well as an overall or total quality of life score. Depression was measured with the Centers of Epidemiological Studies Depression Scale, In 19 patients, exercise tolerance was determined with the 6-min walking distance, Results: Gen eral fatigue correlated with FEV1, percent predicted (r = -0.32, p < 0 .05), exercise tolerance (r = -0.55, p < 0.05), depression (r = 0.44, p < 0.01), and overall quality of life (r = 0.75, p < 0.01), Among the dimensions of fatigue, depression correlated with general and mental fatigue only. Physical dimensions of fatigue correlated with an increa se in the severity of pulmonary impairment and reduction in exercise t olerance. The cognitive components of fatigue, such as reduction in mo tivation and mental fatigue, were not found to be highly correlated wi th physical dimensions of quality of life. All five subscales of fatig ue showed relationship to the functional impact dimension and total im pairment score in quality of life. Conclusions: These data show a rela tionship between dimensions of fatigue and pulmonary function, exercis e tolerance, and quality of life in COPD. Based on these results, fati gue is an important symptom requiring evaluation and management in pat ients with COPD, These data clarified also the relationship between de pression and fatigue in this patient population.