Fatigue is highly prevalent in patients with COPD and correlates
poorly with the degree of airflow limitation

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Abstract

Background:

The objective of this study was to compare fatigue levels between subjects with and without COPD, and to investigate the relationship between fatigue, demographics, clinical features and disease severity.

Methods:

A total of 1290 patients with COPD [age 65 ± 9 years, 61% male, forced expiratory volume in 1 s (FEV1) 56 ± 19% predicted] and 199 subjects without COPD (age 63 ± 9 years, 51% male, FEV1 112 ± 21% predicted) were assessed for fatigue (Checklist Individual Strength-Fatigue), demographics, clinical features and disease severity.

Results:

Patients with COPD had a higher mean fatigue score, and a higher proportion of severe fatigue (CIS-Fatigue score 35 ± 12 versus 21 ± 11 points, p < 0.001; 49 versus 10%, p < 0.001). Fatigue was significantly, but poorly, associated with the degree of airflow limitation [FEV1 (% predicted) Spearman correlation coefficient = −0.08, p = 0.006]. Multiple regression indicated that 30% of the variance in fatigue was explained by the predictor variables.

Conclusions:

Severe fatigue is prevalent in half of the patients with COPD, and correlates poorly with the degree of airflow limitation. Future studies are needed to better understand the physical, psychological, behavioural, and systemic factors that precipitate or perpetuate fatigue in COPD.

Related collections

Most cited references 46

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Dimensional assessment of chronic fatigue syndrome.

Jan H.M.M. Vercoulen, Caroline Swanink, Jan F.M. Fennis … (1994)

The absence of laboratory tests and clear criteria to identify homogeneous (sub)groups in patients presenting with unexplained fatigue, and to assess clinical status and disability in these patients, calls for further assessment methods. In the present study, a multi-dimensional approach to the assessment of chronic fatigue syndrome (CFS) is evaluated. Two-hundred and ninety-eight patients with CFS completed a set of postal questionnaires that assessed the behavioural, emotional, social, and cognitive aspects of CFS. By means of statistical analyses nine relatively independent dimensions of CFS were identified along which CFS-assessment and CFS-research can be directed. These dimensions were named: psychological well-being, functional impairment in daily life, sleep disturbances, avoidance of physical activity, neuropsychological impairment, causal attributions related to the complaints, social functioning, self-efficacy expectations, and subjective experience of the personal situation. A description of the study sample on these dimensions is presented.

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The assessment of fatigue: Psychometric qualities and norms for the Checklist individual strength.

M Worm-Smeitink, M. Gielissen, L Bloot … (2017)

The Checklist Individual Strength (CIS) measures four dimensions of fatigue: Fatigue severity, concentration problems, reduced motivation and activity. On the fatigue severity subscale, a cut-off score of 35 is used. This study 1) investigated the psychometric qualities of the CIS; 2) validated the cut-off score for severe fatigue and 3) provided norms.

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Nutritional assessment and therapy in COPD: a European Respiratory Society statement.

Annemie M. W. J. Schols, Ivone M Ferreira, Frits Franssen … (2014)

Nutrition and metabolism have been the topic of extensive scientific research in chronic obstructive pulmonary disease (COPD) but clinical awareness of the impact dietary habits, nutritional status and nutritional interventions may have on COPD incidence, progression and outcome is limited. A multidisciplinary Task Force was created by the European Respiratory Society to deliver a summary of the evidence and description of current practice in nutritional assessment and therapy in COPD, and to provide directions for future research. Task Force members conducted focused reviews of the literature on relevant topics, advised by a methodologist. It is well established that nutritional status, and in particular abnormal body composition, is an important independent determinant of COPD outcome. The Task Force identified different metabolic phenotypes of COPD as a basis for nutritional risk profile assessment that is useful in clinical trial design and patient counselling. Nutritional intervention is probably effective in undernourished patients and probably most when combined with an exercise programme. Providing evidence of cost-effectiveness of nutritional intervention is required to support reimbursement and thus increase access to nutritional intervention. Overall, the evidence indicates that a well-balanced diet is beneficial to all COPD patients, not only for its potential pulmonary benefits, but also for its proven benefits in metabolic and cardiovascular risk.

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Author and article information

Contributors

Yvonne M. J. Goërtz:

ORCID: https://orcid.org/0000-0003-4674-9562

Martijn A. Spruit

Alex J. Van ‘t Hul

Jeannette B. Peters

Maarten Van Herck

Nienke Nakken

Remco S. Djamin

Chris Burtin

Melissa S. Y. Thong

Arnold Coors

Yvonne Meertens-Kerris

Emiel F. M. Wouters

Judith B. Prins

Frits M. E. Franssen

Jean W. M. Muris

Lowie E. G. W. Vanfleteren

Mirjam A. G. Sprangers

Daisy J. A. Janssen

Jan H. Vercoulen

Journal

Journal ID (nlm-ta): Ther Adv Respir Dis

Journal ID (iso-abbrev): Ther Adv Respir Dis

Journal ID (publisher-id): TAR

Journal ID (hwp): sptar

Title: Therapeutic Advances in Respiratory Disease

Publisher: SAGE Publications (Sage UK: London, England )

ISSN (Print): 1753-4658

ISSN (Electronic): 1753-4666

Publication date (Electronic): 27 September 2019

Publication date Collection: Jan-Dec 2019

Volume: 13

Electronic Location Identifier: 1753466619878128

Affiliations

[1-1753466619878128]Department of Research and Education, Ciro, Centre of Expertise for Chronic Organ Failure, Horn, NM 6085, the Netherlands

[2-1753466619878128]Department of Research and Education, Ciro, Centre of Expertise for Chronic Organ Failure, Horn, NM, the Netherlands

[3-1753466619878128]REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium

[4-1753466619878128]Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands

[5-1753466619878128]NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands

[6-1753466619878128]Department of Pulmonary Disease, Radboud University Medical Center, Nijmegen, the Netherlands

[7-1753466619878128]Department of Pulmonary Disease, Radboud University Medical Center, Nijmegen, the Netherlands

[8-1753466619878128]Department of Medical Psychology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands

[9-1753466619878128]REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium

[10-1753466619878128]Department of Research and Education, Ciro, Centre of Expertise for Chronic Organ Failure, Horn, the Netherlands

[11-1753466619878128]Department of Respiratory Medicine, Amphia Ziekenhuis, Breda, the Netherlands

[12-1753466619878128]REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium

[13-1753466619878128]Department of Medical Psychology, Amsterdam University Medical Centres, location AMC, Amsterdam, the Netherlands

[14-1753466619878128]Member of the Patient Advisory Board, Radboud University Medical Center, Nijmegen, the Netherlands

[15-1753466619878128]Member of the Patient Advisory Board, Ciro, Centre of Expertise for Chronic Organ Failure, Horn, the Netherlands

[16-1753466619878128]Department of Research and Education, Ciro, Centre of Expertise for Chronic Organ Failure, Horn, the Netherlands

[17-1753466619878128]Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands

[18-1753466619878128]Department of Medical Psychology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands

[19-1753466619878128]Department of Research and Education, Ciro, Centre of Expertise for Chronic Organ Failure, Horn, the Netherlands

[20-1753466619878128]Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands

[21-1753466619878128]NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands

[22-1753466619878128]Department of Family Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands

[23-1753466619878128]Department of Research and Education, Ciro, Centre of Expertise for Chronic Organ Failure, Horn, the Netherlands

[24-1753466619878128]Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands

[25-1753466619878128]COPD Center, Sahlgrenska University, Gothenburg, Sweden

[26-1753466619878128]Department of Medical Psychology, Amsterdam University Medical Centres, location AMC, Amsterdam, the Netherlands

[27-1753466619878128]Department of Research and Education, Ciro, Centre of Expertise for Chronic Organ Failure, Horn, the Netherlands

[28-1753466619878128]Centre of Expertise for Palliative Care, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands

[29-1753466619878128]Department of Pulmonary Disease, Radboud University Medical Center, Nijmegen, the Netherlands

[30-1753466619878128]Department of Medical Psychology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands

Author notes

[*] yvonnegoertz@ 123456ciro-horn.nl

Author information

Yvonne M. J. Goërtz https://orcid.org/0000-0003-4674-9562

Article

Publisher ID: 10.1177_1753466619878128

DOI: 10.1177/1753466619878128

PMC ID: 6767724

PubMed ID: 31558115

SO-VID: e3ed9a3f-c6ae-41d9-84e8-4cedcc57d4f3

License:

This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

History

Date received : 11 January 2019

Date accepted : 13 August 2019

Funding

Funded by: CIRO, the Netherlands, ;

Funded by: universiteit hasselt, FundRef https://doi.org/10.13039/501100009550;

Funded by: astrazeneca, FundRef https://doi.org/10.13039/100004325;

Funded by: Lung foundation Netherlands, ;

Award ID: 3.4.12.024

Funded by: Lung foundation Netherlands, ;

Award ID: 4.1.16.085

Funded by: stichting astma bestrijding, FundRef https://doi.org/10.13039/501100004344;

Funded by: boehringer ingelheim, FundRef https://doi.org/10.13039/100001003;

Custom metadata

cover-date January-December 2019

Keywords: airway obstruction,chronic obstructive pulmonary disease,fatigue

Data availability:

Keywords: airway obstruction, chronic obstructive pulmonary disease, fatigue

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Fatigue is highly prevalent in patients with COPD and correlates poorly with the degree of airflow limitation

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Abstract

Background:

Methods:

Results:

Conclusions:

Related collections

Biomarkers for Inflammatory Lung Disease

Most cited references 46

Dimensional assessment of chronic fatigue syndrome.

The assessment of fatigue: Psychometric qualities and norms for the Checklist individual strength.

Nutritional assessment and therapy in COPD: a European Respiratory Society statement.

Author and article information

Contributors

Journal

Affiliations

Author notes

Author information

Article

History

Funding

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Custom metadata

Comments

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Similar content 259

Cited by 19

Most referenced authors 779