People with COPD have greater participation restrictions than age-matched older adults without respiratory conditions assessed during the COVID-19 pandemic

Sachi O'Hoski; Ayse Kuspinar; Joshua Wald; Julie Richardson; Roger Goldstein; Marla K Beauchamp

doi:10.1371/journal.pone.0275264

People with COPD have greater participation restrictions than age-matched older adults without respiratory conditions assessed during the COVID-19 pandemic

PLoS One. 2022 Oct 4;17(10):e0275264. doi: 10.1371/journal.pone.0275264. eCollection 2022.

Authors

Sachi O'Hoski^{1

2}, Ayse Kuspinar¹, Joshua Wald^{1

3}, Julie Richardson¹, Roger Goldstein², Marla K Beauchamp^{1

2

3}

Affiliations

¹ School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.
² Respiratory Research, West Park Healthcare Centre, Toronto, ON, Canada.
³ Firestone Institute for Respiratory Health, St. Joseph's Healthcare, Hamilton, ON, Canada.

Abstract

Background: Participation restriction has detrimental effects for older adults but it is unknown how participation differs for people with chronic obstructive pulmonary disease (COPD) compared to older adults of the same age without respiratory conditions. We compared scores on the Late Life Disability Instrument (LLDI) between people with COPD (study group) and a random sample of older adults (control group).

Methods: Participants with COPD (study group) were recruited from two hospitals in Ontario and age- and sex-matched with a ratio of 1:2 with participants from a random sample of community-dwelling older adults who did not report having respiratory conditions (control group). The study group completed the LLDI prior to the COVID-19 pandemic and the control group completed the LLDI at the end of the first wave of the pandemic. LLDI frequency and limitation scores were compared between groups using Wilcoxon rank-sum tests.

Results: Forty-six study group participants (mean age 74.2 (SD 5.5) years) and 92 control group participants (mean age 74.4 (SD 5.4) years) were included. Fifty-four percent of the participants were female. The majority of the study group had severe COPD (median forced expiratory volume in one second of 34.5 (25th-75th percentile 27.0-56.0) % predicted). LLDI sores were lower for the study group compared to the control group for both the frequency (median difference -5.4 points, p<0.001) and limitation (median difference -7.6 points, p<0.001) domains. The personal subscale demonstrated the largest magnitude of difference between groups (median difference -13.4 points) and the social subscale demonstrated the smallest magnitude of difference (-5.2 points).

Conclusion: People with COPD had greater participation restrictions than a random sample of older adults without ongoing respiratory conditions. The differences seen in participation between the two groups may have been reduced due to temporal confounding from the COVID-19 pandemic. While participation is relevant to all older adults, our results suggest that it is especially important that it be assessed in those with COPD.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
COVID-19* / epidemiology
Female
Forced Expiratory Volume
Humans
Male
Pandemics
Pulmonary Disease, Chronic Obstructive* / epidemiology
Quality of Life
Respiration Disorders*
Respiratory Function Tests

Grants and funding

SO is funded by a Vanier Canada Graduate Scholarship and MKB is supported by a Canada Research Chair in Mobility, Aging and Chronic Disease (Tier 2). The primary studies were completed with the support of an Ontario Respiratory Care Society Grant and a Labarge COVID-19 Grant from the McMaster Institute for Research on Aging. At the time of data collection SO was also supported by an Ontario Respiratory Care Society fellowship and a Breathing as One Fellowship from the Canadian Lung Association. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.