The association of chronic obstructive pulmonary disease, disability, engagement in social activities, and mortality among US adults aged 70 years or older, 1994–2006

Abstract

Yong Liu,1 Janet B Croft,1 Lynda A Anderson,2 Anne G Wheaton,1 Letitia R Presley-Cantrell,3 Earl S Ford11Epidemiology and Surveillance Branch, 2Healthy Aging Program, Division of Population Health, CDC and Rollins School of Public Health, Emory University, 3Program Development and Services Management, Division of Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USAPurpose: To assess associations among chronic obstructive pulmonary disease (COPD), disability as measured by activities of daily living (ADL) and instrumental ADL (IADL), engagement in social activities, and death among elderly noninstitutionalized US residents.Materials and methods: A nationally representative sample of 9,415 adults who were aged ≥70 years and responded to the Second Supplement on Aging survey in 1994–1996 and mortality follow-up study through 2006 were assessed. Multiple logistic regression analyses were performed to assess the risk of all-cause mortality in participants with COPD after accounting for age, sex, race/ethnicity, and smoking status.Results: At baseline, approximately 9.6% of study participants reported having COPD. Compared with participants without COPD, those with COPD were significantly more likely (P<0.05) to have difficulty with at least one ADL (44.3% versus [vs] 27.5%) and with at least one IADL (59.9% vs 40.2%), significantly less likely to be engaged in social activities (32.6% vs 26.3%), and significantly more likely to die by 2006 (70.7% vs 60.4%; adjusted risk ratio 1.15, P<0.05). The association between COPD and risk for death was moderately attenuated by disability status.Conclusion: COPD is positively associated with disability and mortality risk among US adults aged ≥70 years. The significant relationship between COPD and mortality risk was moderately attenuated, but was not completely explained by stages of ADL and IADL limitations and social activities.Keywords: chronic obstructive pulmonary disease, mortality, activities of daily living, instrumental activities of daily living, disability