Co-morbidities are the key nominators of the health related quality of life in mild and moderate COPD

Jukka Koskela, Maritta Kilpeläinen, Henna Elina Kupiainen, Witold Mazur, Harri Sintonen, Marike Boezen, Ari Lindqvist, Dirkje Postma, Tarja Helena Laitinen

Research output: Contribution to journalArticleScientificpeer-review



Co-morbidities are common in chronic obstructive pulmonary disease (COPD). We assessed the contribution of common co-morbidities on health related quality of life (HRQoL) among COPD patients.


Using both generic (15D) and respiratory-specific (AQ20) instruments, HRQoL was assessed in a hospital based COPD population (N = 739, 64% males, mean age 64 years, SD 7 years) in this observational study with inferential analysis. The prevalence of their co-morbidities was compared with those of 5000 population controls. The patients represented all severity stages of COPD and the patterns of common concomitant disorders differed between patients.


Co-morbidities such as psychiatric conditions, alcohol abuse, cardiovascular diseases, and diabetes were more common among COPD patients than in age and gender matched controls. Psychiatric conditions and alcohol abuse were the strongest determinants of HRQoL in COPD and could be detected by both 15D (Odds Ratio 4.7 and 2.3 respectively) and AQ20 (OR 2.0 and 3.0) instruments. Compared to respiratory specific AQ20, generic 15D was more sensitive to the effects of comorbidities while AQ20 was slightly more sensitive for the low FEV1. FEV1 was a strong determinant of HRQoL only at more severe stages of disease (FEV1 < 40% of predicted). Poor HRQoL also predicted death during the next five years.


The results suggest that co-morbidities may impair HRQoL at an early stage of the disease, while bronchial obstruction becomes a significant determinant of HRQoL only in severe COPD.
Original languageEnglish
Article number102
JournalBMC Pulmonary Medicine
Number of pages11
Publication statusPublished - 19 Jun 2014
MoE publication typeA1 Journal article-refereed

Fields of Science

  • 3142 Public health care science, environmental and occupational health
  • generic HRQoL
  • respiratory specific HRQoL
  • HRQoL
  • COPD
  • 15D
  • AQ20
  • co-morbidities
  • mortality
  • 3121 General medicine, internal medicine and other clinical medicine

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