Beyond the Lungs: The Role of Extrapulmonary Manifestations in the Quality of Life of Indians with Chronic Airway Diseases.

👤 Authors: Rohini Bhadra, S Sucharita, George D'Souza, Sumithra Selvam, Annemie M W J Schols

📋DOI: 10.1016/j.rmed.2026.108872↗

📰 Publication: Respiratory Medicine↗

#Asthma, Body_composition, Bronchiectasis, Depression, EXERCISE, Lung, Muscle_strength, muscles, Osteoporosis, Pulmonary_disease,_chronic_obstructive, Quality_of_life

ABSTRACT:

PURPOSE

Chronic airway diseases (CAD) including Chronic obstructive pulmonary diseases (COPD), persistent asthma (≥2weekly episodes) and bronchiectasis, exhibit overlapping extrapulmonary manifestations potentially affecting health-related quality-of-life (HRQOL). The study objective was to quantify HRQOL of CAD patients and identify impact of associated pulmonary and extrapulmonary manifestations.

METHODOLOGY

Total 101 established CAD patients were recruited cross-sectionally (COPD, n=61, persistent asthma, n=30 and bronchiectasis, n=10).

Patients completed spirometry, body composition (Dual-energy X-ray Absorptiometry), muscle function (isometric and isokinetic dynamometry), exercise capacity (6-minute walking distance,6MWD) and patient reported outcomes including physical activity, sleep and Hospital-Anxiety-and-Depression-Scale. HRQOL was assessed using EuroQol quality-of-life questionnaire and utility score (EQ-5D index) was stratified into tertiles to compare patient characteristics.

RESULT

Mean age of participants was 60.9±12.8y, and 25.7% were female.

Mean EQ-5D index was 0.658(95%CI: 0.596, 0.721), significantly lower than population norms and other chronic diseases including diabetes, cardiovascular diseases and rheumatoid heart disease (p<0.01). Participants in lowest EQ-5D tertile were older, had higher depression, lower 6MWD, lower handgrip and quadriceps muscle strength than other two tertiles, whereas anxiety was higher in both lowest and intermediate tertile compared to highest tertile(p<0.01).

In adjusted regression model, age (AOR:1.187) depression (AOR:1.438), anxiety (AOR:1.266), and body fat (AOR:1.114) showed increased odds for poor EQ-5D index while in intermediate vs highest EQ-5D tertile, only age (AOR: 1.125) and anxiety (AOR:1.403) showed a significant association.

CONCLUSION

HRQOL is significantly lower in CAD compared to other chronic non-communicable diseases and significantly associated with extrapulmonary manifestations. Interventions targeting modifiable risk factors may aid in improving HRQOL in CAD.