Date Published: July 20, 2017
Publisher: Public Library of Science
Author(s): Judith A. Okely, Seif O. Shaheen, Alexander Weiss, Catharine R. Gale, Christophe Leroyer.
Previous studies indicate that psychosocial factors can impact COPD prevalence. However, research into this association has predominantly focused on negative factors such as depression. The aim of this study was to examine whether high subjective wellbeing is associated with a lower risk of developing COPD.
The sample consisted of 12,246 participants aged ≥50 years from the Survey of Health, Ageing and Retirement in Europe. We used Cox proportional hazards regression to examine the relationship between wellbeing (measured using the CASP-12) and incidence of COPD over a follow-up period of 9 years.
There was a significant association between wellbeing and COPD risk. In age-adjusted analyses, a standard deviation increase in CASP-12 score was associated with a reduced risk of COPD; hazard ratios (95% confidence intervals) for men and women were 0.67 (0.60–0.75) and 0.80 (0.73–0.87) respectively. After additional adjustment for demographic and health behaviour variables, this association remained significant for men but not for women: the fully-adjusted hazard ratios were 0.80 (0.70–0.91) and 0.91 (0.82–1.03) respectively.
Greater wellbeing is associated with a reduced risk of COPD, particularly in men. Future research is needed to establish whether gender reliably moderates this association.
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide . This progressive disease is characterised by persistent airflow limitation caused by a combination of small airways disease (obstructive bronchiolitis) and emphysema . Established risk factors for COPD include smoking, exposure to air pollutants, chronic lung infections, older age and genetic factors . Recent reports suggest that prevalence rates of COPD may have stabilised in some developed countries as a result of reduced smoking prevalence . Given this recent decline in tobacco use, Rosenberg et al.  suggest that future trends in the prevalence of COPD will be driven by factors other than smoking prevalence.
Table 1 shows the baseline characteristics of the sample (n = 12,246) according to tertiles of wellbeing. Mean wellbeing scores for the lowest, middle and highest tertiles were 30.67 (SD = 3.92), 38.06 (SD = 1.41) and 43.48 (SD = 1.94) respectively. On average, participants with higher wellbeing were younger, taller, wealthier, more educated, more likely to be male, less likely to report a history of chronic disease excluding asthma and less likely to smoke. They also had lower depressive symptom scores, lower BMI, were more physically active and consumed more alcohol.
This study successfully replicated the finding that wellbeing is protective against COPD risk . The association between higher CASP-12 scores remained significant following additional adjustment for covariate variables (wealth, education, height, depressive symptoms, comorbidities, health behaviours and BMI) in men but not in women.