Analysis of comorbid factors that increase the COPD assessment test scores

Masaki Miyazaki, Hidetoshi Nakamura, Shotaro Chubachi, Mamoru Sasaki, Mizuha Haraguchi, Shuichi Yoshida, Keishi Tsuduki, Toru Shirahata, Saeko Takahashi, Naoto Minematsu, Hidefumi Koh, Morio Nakamura, Fumio Sakamaki, Takeshi Terashima, Koichi Sayama, Paul W. Jones, Koichiro Asano, Tomoko Betsuyaku, Takashi Inoue, Naoki MiyaoKazumi Nishio, Hiroki Tateno, Yoshitaka Oyamada, Tatsu Matsuzaki, Akira Umeda

Research output: Contribution to journalArticlepeer-review

79 Citations (Scopus)


Background: The chronic obstructive pulmonary disease (COPD) Assessment Test (CAT) is a concise health status measure for COPD. COPD patients have a variety of comorbidities, but little is known about their impact on quality of life. This study was designed to investigate comorbid factors that may contribute to high CAT scores.Methods: An observational study at Keio University and affiliated hospitals enrolled 336 COPD patients and 67 non-COPD subjects. Health status was assessed by the CAT, the St. Georges Respiratory Questionnaire (SGRQ), and all components of the Medical Outcomes Study Short-Form 36-Item (SF-36) version 2, which is a generic measure of health. Comorbidities were identified based on patients' reports, physicians' records, and questionnaires, including the Frequency Scale for the Symptoms of Gastro-esophageal reflux disease (GERD) and the Hospital Anxiety and Depression Scale. Dual X-ray absorptiometry measurements of bone mineral density were performed.Results: The CAT showed moderate-good correlations with the SGRQ and all components of the SF-36. The presence of GERD, depression, arrhythmia, and anxiety was significantly associated with a high CAT score in the COPD patients.Conclusions: Symptomatic COPD patients have a high prevalence of comorbidities. A high CAT score should alert the clinician to a higher likelihood of certain comorbidities such as GERD and depression, because these diseases may co-exist unrecognized. Trial registration: Clinical trial registered with UMIN (UMIN000003470).

Original languageEnglish
Article number13
JournalRespiratory Research
Issue number1
Publication statusPublished - 2014 Feb 6


  • Chronic obstructive pulmonary disease
  • Comorbidity
  • Depression
  • Gastro-esophageal reflux
  • Health status
  • Osteoporosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


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