Fast overall decline was associated with the presence of acute exacerbation(s) (44% of the subjects with exacerbation(s) versus 17% of subjects without exacerbation, p = 0.03). Subjects with airflow obstruction had a 2.5 (95% CI 1.36–4.71) higher risk of presenting fast overall health status decline. Characteristics of the fast declining group were older age, worse lung function, physical fitness, physical activity and disease specific baseline health status. Subjects presenting at least one exacerbation had faster rate of deterioration measured with CAT. On average, health status decline did not differ between groups with the exception of the EQ-5D index, which deteriorated faster in subjects with airflow obstruction compared to the never smoking control group. Other functional outcomes comprised measures of lung function, physical fitness, physical activity and emotional state. Generic and disease specific health status questionnaires were regularly repeated over a six years period. Two hundred and one subjects were included.
Second, to investigate the factors potentially associated to rapid health status decline in our total cohort. To investigate the long term change of health status in subjects with mild to moderate airflow obstruction and to compare this to subjects without airflow obstruction, with and without a smoking history. Patients with COPD need to cope with a disabling disease, which leads to health status impairment.
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