Respiratory symptoms in adults are related to impaired quality of life, regardless of asthma and COPD: results from the European community respiratory health survey

Abstract

BackgroundRespiratory symptoms are common in the general population, and their presence is related to Health-related quality of life (HRQoL). The objective was to describe the association of respiratory symptoms with HRQoL in subjects with and without asthma or COPD and to investigate the role of atopy, bronchial hyperresponsiveness (BHR), and lung function in HRQoL.MethodsThe European Community Respiratory Health Survey (ECRHS) I and II provided data on HRQoL, lung function, respiratory symptoms, asthma, atopy, and BHR from 6009 subjects. Generic HRQoL was assessed through the physical component summary (PCS) score and the mental component summary (MCS) score of the SF-36.Factor analyses and linear regressions adjusted for age, gender, smoking, occupation, BMI, comorbidity, and study centre were conducted.ResultsHaving breathlessness at rest in ECRHS II was associated with mean score (95% CI) impairment in PCS of -8.05 (-11.18, -4.93). Impairment in MCS score in subjects waking up with chest tightness was -4.02 (-5.51, -2.52). The magnitude of HRQoL impairment associated with respiratory symptoms was similar for subjects with and without asthma/COPD. Adjustments for atopy, BHR, and lung function did not explain the association of respiratory symptoms and HRQoL in subjects without asthma and/or COPD.ConclusionSubjects with respiratory symptoms had poorer HRQoL; including subjects without a diagnosis of asthma or COPD. These findings suggest that respiratory symptoms in the absence of a medical diagnosis of asthma or COPD are by no means trivial, and that clarifying the nature and natural history of respiratory symptoms is a relevant challenge.Several community studies have estimated the prevalence of common respiratory symptoms like cough, dyspnoea, and wheeze in adults [1-3]. Although the prevalence varies to a large degree between studies and geographical areas, respiratory symptoms are quite common. The prevalences of respiratory symptoms in the European Community Respiratory Health Study (ECRHS) varied from one percent to 35% [1]. In fact, two studies have reported that more than half of the adult population suffers from one or more respiratory symptoms [4,5].Respiratory symptoms are important markers of the risk of having or developing disease. Respiratory symptoms have been shown to be predictors for lung function decline [6-8], asthma [9,10], and even all-cause mortality in a general population study [11]. In patients with a known diagnosis of asthma or chronic obstructive pulmonary disease (COPD), respiratory symptoms are important determinants of reduced health related quality of life (HRQoL) [12-15]. The prevalence of respiratory symptoms exceeds the combined prevalences of asthma and COPD, and both asthma and COPD are frequently undiagnosed diseases [16-18]. Thus, the high prevalence of respipratory symptoms may mirror undiagnosed and untreated disease.The common occurrence of respiratory symptoms calls for attention to how these symptoms affect health also in subjects with no diagnosis of obstructive ...

Health-related quality of life of patients with asthma: a cross-sectional study in Semnan, Islamic Republic of Iran

“…Our study showed found lower QoL scores in asthma patients than in the general population, which concurs with the results of other studies in this field which used different scales (10,11).…”

“…Similar to the results of our study, a European study found significantly lower PCS scores in manual workers (11). Manual workers are more likely to be exposed to allergens than office workers (3).…”

“…Manual workers are more likely to be exposed to allergens than office workers (3). However, different job classifications between countries make the interpretation of contradictory results difficult (11,30,31).…”

“…The Persian version of SF-36 questionnaire was used to evaluate QoL (11,15 (17). Participants are scored individually in each area (0 = worst to 100 = best); the lower the score the lower the QoL.…”

The asthma knowledge and perceptions of older Australian adults: Implications for social marketing campaigns

“…Not previously examined in older adult populations, our findings build upon the evidence that experience of breathlessness alone, regardless of asthma diagnosis, is associated with poorer ratings of general health and worse health-related quality of life 38 . Therefore, future studies examining health-related quality of life should control for experience of respiratory symptoms rather than merely the presence or absence of diagnosed respiratory diseases.…”