Chronic Obstructive Pulmonary Disease and Arthritis Among US Adults, 2016

Yong Liu, MD, MS; Anne G. Wheaton, PhD; Louise B. Murphy, PhD; Fang Xu, PhD; Janet B. Croft, PhD; Kurt J. Greenlund, PhD

Disclosures

Prev Chronic Dis. 2019;16(7):e93 

In This Article

Abstract and Introduction

Abstract

Introduction: More than 54 million US adults have arthritis, and more than 15 million US adults have chronic obstructive pulmonary disease (COPD). Arthritis and COPD share many risk factors, such as tobacco use, asthma history, and age. The objective of this study was to assess the relationship between self-reported physician-diagnosed COPD and arthritis in the US adult population.

Methods: We analyzed data from 408,774 respondents aged 18 or older in the 2016 Behavioral Risk Factor Surveillance System to assess the association between self-reported physician-diagnosed COPD and arthritis in the US adult population by using multivariable logistic regression analyses.

Results: Overall crude prevalence was 6.4% for COPD and 25.2% for arthritis. The prevalence of age-adjusted COPD was higher among respondents with arthritis than among respondents without arthritis (13.7% vs 3.8%, P < .001). The association remained significant among most subgroups (P < .001) particularly among adults aged 18 to 44 (11.5% vs 2.0%) and never smokers (7.6% vs 1.7%). In multivariable logistic regression analyses, arthritis status was significantly associated with COPD status after controlling for sociodemographic characteristics, risk behaviors, and health-related quality of life measures (adjusted prevalence ratio = 1.5, 95% confidence interval, 1.4–1.5, P < .001).

Conclusion: Our results confirmed that arthritis is associated with a higher prevalence of COPD in the US adult population. Health care providers may assess COPD and arthritis symptoms for earlier detection of each condition and recommend that patients with COPD and/or arthritis participate in pulmonary rehabilitation and self-management education programs such as the Chronic Disease Self-Management Program, the proven benefits of which include increased aerobic activity and reduced shortness of breath, pain, and depression.

Introduction

More than 15 million US adults have chronic obstructive pulmonary disease (COPD), and more than 54 million US adults have arthritis.[1,2] COPD is characterized by progressive, irreversible airflow limitation and was the fourth leading cause of death in the United States in 2016.[3] Arthritis is a common chronic condition and a leading cause of disability.[4] Data from cross-sectional studies suggest that adults with COPD are more likely than adults without COPD to have arthritis,[5] including osteoarthritis[6] and rheumatoid arthritis.[7] Emerging evidence from longitudinal studies also shows a higher risk of developing COPD among adults with arthritis than adults without arthritis at baseline.[8–11] COPD and arthritis share many of the same risk factors, such as sex, age, lower socioeconomic status, tobacco use, obesity, and infection.[12–14] Most previous studies assessed the COPD–arthritis relationship by controlling for those common risk factors.[9–11] However, few studies, including nationally representative studies, examined the relationship among subgroups with or without those risk factors.[5,11] Describing these relationships may inform health care providers to assess COPD and arthritis symptoms for earlier detection of these conditions and provide new insights into preventing them.

The objective of this study was to assess the relationship between self-reported physician-diagnosed COPD and arthritis in the US adult population aged 18 or older in the 2016 Behavioral Risk Factor Surveillance System (BRFSS). We examined the relationship among subgroups with and without the common risk factors.

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