COPD, 12:190–198, 2015 ISSN: 1541-2555 print / 1541-2563 online Copyright © Informa Healthcare USA, Inc. DOI: 10.3109/15412555.2014.922175
ORIGINAL RESEARCH
Psychosocial Risk Factors for Hospitalisation and Death from Chronic Obstructive Pulmonary Disease: A Prospective Cohort Study Alice J. Clark,1,2 Katrine Strandberg-Larsen,1 Jolenee L. Masters Pedersen,1,2 Peter Lange,1,3,4 Eva Prescott,3,5 and Naja Hulvej Rod1,2 1
Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
2
The Copenhagen Stress Research Center, Copenhagen, Denmark
3
The Copenhagen City Heart Study, Frederiksberg University Hospital, Frederiksberg, Denmark
4
Department of Heart and Lung Diseases, Hvidovre University Hospital, Hvidovre, Denmark
5
Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark
Abstract Only a few smaller studies have addressed the effect of psychosocial factors on risk of chronic obstructive pulmonary disease (COPD) in spite of the potential for psychosocial stress to affect development of the disease through immunological and behavioural pathways. The aim of this study is to determine the relation between various psychosocial risk factors, individually and accumulated, and COPD hospitalisation and deaths. A total of 8728 women and men free of asthma and COPD participating in the Copenhagen City Heart Study, were asked comprehensive questions on major life events, work-related stress, social network, vital exhaustion, economic hardship, and sleep medication in 1991–1993 and followed in nationwide registers until 2009, with 8, d) adverse structural aspects of social network: not cohabiting and no contact to family and/or friends, e) adverse functional aspects of social network: no confidant and/or dissatisfaction with social network, f ) economic hardship, and g) daily use of sleep medication. The accumulation of psychosocial risk factors was categorised into 0-1, 2, 3 and >3 factors.
Covariates Covariates included age, lung function at baseline (80 FEV1% pred), education (24 cigarettes/day), physical activity in leisure time (sedentary or very light activity, 2–4 hours of light activity per week, >4 hours of light activity or 2–4 hours of high level activity, and competitional level or >4 hours of hard level activity per week), BMI (
ORIGINAL RESEARCH
Psychosocial Risk Factors for Hospitalisation and Death from Chronic Obstructive Pulmonary Disease: A Prospective Cohort Study Alice J. Clark,1,2 Katrine Strandberg-Larsen,1 Jolenee L. Masters Pedersen,1,2 Peter Lange,1,3,4 Eva Prescott,3,5 and Naja Hulvej Rod1,2 1
Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
2
The Copenhagen Stress Research Center, Copenhagen, Denmark
3
The Copenhagen City Heart Study, Frederiksberg University Hospital, Frederiksberg, Denmark
4
Department of Heart and Lung Diseases, Hvidovre University Hospital, Hvidovre, Denmark
5
Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark
Abstract Only a few smaller studies have addressed the effect of psychosocial factors on risk of chronic obstructive pulmonary disease (COPD) in spite of the potential for psychosocial stress to affect development of the disease through immunological and behavioural pathways. The aim of this study is to determine the relation between various psychosocial risk factors, individually and accumulated, and COPD hospitalisation and deaths. A total of 8728 women and men free of asthma and COPD participating in the Copenhagen City Heart Study, were asked comprehensive questions on major life events, work-related stress, social network, vital exhaustion, economic hardship, and sleep medication in 1991–1993 and followed in nationwide registers until 2009, with 8, d) adverse structural aspects of social network: not cohabiting and no contact to family and/or friends, e) adverse functional aspects of social network: no confidant and/or dissatisfaction with social network, f ) economic hardship, and g) daily use of sleep medication. The accumulation of psychosocial risk factors was categorised into 0-1, 2, 3 and >3 factors.
Covariates Covariates included age, lung function at baseline (80 FEV1% pred), education (24 cigarettes/day), physical activity in leisure time (sedentary or very light activity, 2–4 hours of light activity per week, >4 hours of light activity or 2–4 hours of high level activity, and competitional level or >4 hours of hard level activity per week), BMI (
