Ritsuko Wakabayashi

Gender-associated differences in dyspnoea and health-related quality of life in patients with chronic obstructive pulmonary disease

Background and objectives:  Recent studies have reported several gender‐associated differences among patients with COPD, but gender‐associated differences in health‐related quality of life (HRQoL) in patients with COPD have not yet been clarified. This study evaluated gender differences in dyspnoea and HRQoL in patients with COPD.

Long-term effectiveness of an inpatient pulmonary rehabilitation program for elderly COPD patients: comparison between young-elderly and old-elderly groups.

Objective:  To evaluate the long‐term effects of pulmonary rehabilitation in elderly COPD patients, we monitored patients for 1 year after they completed a 2‐week inpatient pulmonary rehabilitation program. We also compared the effects of pulmonary rehabilitation on young‐elderly (age 65–74 years) and old‐elderly (age 75 years or over) COPD patients.

Excessive visceral fat accumulation in advanced chronic obstructive pulmonary disease

Background: Previous studies have suggested links between chronic obstructive pulmonary disease (COPD), cardiovascular disease, and abdominal obesity. Although abdominal visceral fat is thought to be associated with cardiovascular risk factors, the degree of visceral fat accumulation in patients with COPD has not been directly studied. The aim of this study was to investigate the abdominal visceral fat accumulation and the association between visceral fat and the severity and changes in emphysema in COPD patients. Methods: We performed clinical and laboratory tests, including pulmonary function, dyspnea score, and the six-minute walking test in COPD patients (n = 101) and control, which included subjects with a smoking history but without airflow obstruction (n = 62). We used computed tomography to evaluate the abdominal visceral fat area (VFA), subcutaneous fat area (SFA), and the extent of emphysema. Results: The COPD group had a larger VFA than the control group. The prevalence of non-obese subjects with an increased VFA was greater in the Global Initiative for Chronic Obstructive Lung Disease Stages III and IV than in the other stages of COPD. The extent of emphysema was inversely correlated with waist circumference and SFA. However, VFA did not decrease with the severity of emphysema. VFA was positively correlated with the degree of dyspnea. Conclusion: COPD patients have excessive visceral fat, which is retained in patients with more advanced stages of COPD or severe emphysema despite the absence of obesity.

The impact of dyspnoea and leg fatigue during exercise on health-related quality of life in patients with COPD

Objective:  COPD patients frequently complain of symptoms such as dyspnoea and leg fatigue during exercise. However, the impact of these symptoms on the health‐related quality of life (HRQoL) is not known. This study tested whether dyspnoea and leg fatigue during exercise affects the HRQoL of patients with COPD.

Association of serotonin transporter gene variation with smoking, chronic obstructive pulmonary disease, and its depressive symptoms

A serotonin transporter gene, SLC6A4, is thought to be related to nicotine dependence and depression, one of the comorbidities of chronic obstructive pulmonary disease (COPD). To investigate the association between SLC6A4 variation and tobacco consumption, susceptibility to COPD, and depression status. In all, 247 patients with COPD and 119 control subjects were genotyped for 5 tag single-nucleotide polymorphisms (SNPs) of SLC6A4. We analyzed the correlation between these genotypes and COPD, using the results of a pulmonary function test or chest computed tomography; data on tobacco consumption (pack-years); and the depression score based on the hospital anxiety and depression scale (HADS) after adjusting for age, gender, and smoking status (and pack-years, when appropriate). The rare allele rs2020936 was significantly associated with COPD incidence in the trend model (P=0.003; odds ratio, 2.20; 95% confidence interval, 1.31–3.74). This allele was also associated with the number of pack-years (P=0.026). The major allele of another SNP of SLC6A4, namely rs3794808, correlated with the HADS depression score (P=0.016). We conclude that SLC6A4 variation affects COPD pathogenesis, and this effect depends partly on tobacco consumption. SLC6A4 variation also affects depressive symptoms. SLC6A4 could be modified to prevent COPD and treat the depressive symptoms of COPD.

Efficient integrated education for older patients with chronic obstructive pulmonary disease using the Lung Information Needs Questionnaire.

Aim:  Education is a key issue for the long‐term management of chronic obstructive pulmonary disease in older patients. We tested the hypothesis that integrated care focusing on patient information needs for self‐management can improve patient information needs and health outcomes.

Presence of In-Home Caregiver and Health Outcomes of Older Adults with Chronic Obstructive Pulmonary Disease

OBJECTIVES: To determine whether the presence of in‐home caregivers is associated with changes in the health outcomes of older adults with chronic obstructive pulmonary disease (COPD).

Emphysema on imaging is associated with quality of life in elderly patients with chronic obstructive pulmonary disease.

Background:  Limited data are available on the association between the severity of emphysema or airway narrowing, and health‐related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease (COPD), which has been seen to be more prevalent among elderly subjects. The aim of this study was to examine the association between HRQOL, physical parameters and structural alterations in lung of COPD patients.

Effectiveness of home-based exercise in older patients with advanced chronic obstructive pulmonary disease: A 3-year cohort study

To determine whether home‐based exercise can improve clinical outcomes in older patients with advanced chronic obstructive pulmonary disease using long‐term oxygen therapy.