Evaluation of the Characteristics, Anxiety, and Depression Among Older Patients Hospitalized for Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Abstract

SESSION TITLE: COPD Comorbidity PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: To evaluate the characteristics and occurrence of anxiety and depression among older patients hospitalized for acute exacerbation of COPD (AECOPD) in a multi ethnicity population. METHODS: A prospective study was conducted in two major hospitals in Malaysia from January till June 2013. All older (>/=60 years) patients hospitalized with the primary diagnosis of AECOPD were eligible for inclusion. Demographic data, comorbidities, Katz activities of daily living, severity of dyspnoea and COPD were recorded. The occurrence of probable anxiety and depression were assessed using Depression Scale (GDS-15) and Generalized Anxiety Disorder-7 (GAD-7). RESULTS: Thirty seven patients were recruited. The median age was 72.5 (Inter Quartile Range (IQR) 66.5-72) years and 97.3% male gender. Half of the patients were Malay (51.4%), followed by Chinese (37.8%) and Indian (10.8%). More than quarter (29.7%) was current smokers. Previous hospital admission due to COPD in the previous year was common (59.5%), of which, 45.9% with more than one admission. The most common comorbidities were hypertension (48.6%), pneumonia (35.1%), and diabetes (24.2%). Majority of patients were functionally fully independent. Majority of the patients were presented with moderate to severe COPD based on the standardized GOLD criteria. Symptoms of depression were identified in 45.9% of patients (5.4% categorized as severe and 40.5% with mild to moderate depression). Anxiety symptoms were detected in 24.3% of the patients (8.1% had severe anxiety and 27% with mild to moderate anxiety). Almost quarter (21.6%) of the patients were detected to have both anxiety and depression. None of patients included in the study were taking anti-depressive or anxiolytic agents. CONCLUSIONS: Anxiety and depression were found to be relatively common among older patients with AECOPD in the local hospitals. Regular screening for the detection of the symptoms and initiation of appropriate treatment should be encouraged. CLINICAL IMPLICATIONS: Despite the established risk and significant impact of anxiety and depression, these conditions were found to be under diagnosed. Older patients should be screened and treated appropriately to improve their quality of life and medical care. DISCLOSURE: The following authors have nothing to disclose: Sana' AL Aqqad, Irfhan Ali Hyder Ali, Razul Md. Nazri Md. Kassim, Azmi Sarriff, Balamurugan TangiisuranNo Product/Research Disclosure Information.