The influence of social support on COPD outcomes mediated by depression.

TitleThe influence of social support on COPD outcomes mediated by depression.
Publication TypePublication
Year2021
AuthorsTurnier L, Eakin M, Woo H, Dransfield M, Parekh T, Krishnan JA, Kanner R, Cooper CB, Woodruff PG, Wise R, Han MK, Romero K, Paulin LM, Peters S, Drummond B, Bleecker ER, Bowler R, Comellas AP, Couper D, Paine R, Martinez F, Barr G, Putcha N, Hansel NN
JournalPLoS One
Volume16
Issue3
Paginatione0245478
Date Published2021
ISSN1932-6203
KeywordsAdult, Aged, Aged, 80 and over, Cross-Sectional Studies, Depression, DYSPNEA, Female, Humans, Logistic Models, Longitudinal Studies, Male, Middle Aged, Pulmonary Disease, Chronic Obstructive, quality of life, Social Support, Surveys and Questionnaires
Abstract

BACKGROUND: The purpose of this study was to explore the association between perceived social support and COPD outcomes and to determine whether the associations are mediated by depressive symptoms.METHODS: Subjects with COPD who were enrolled as part of SPIROMICS were included in this analysis. Questionnaires relating to quality of life, symptom burden, and functional status were administered at annual clinic visits for over a 3 year period. In both cross-sectional and longitudinal analyses, we examined the association of social support as measured by the FACIT-F with COPD outcomes. Cross sectional analyses used multivariable linear or logistic regression, adjusting for covariates. For longitudinal analyses, generalized linear mixed models with random intercepts were used. Models were adjusted with and without depressive symptoms and mediation analyses performed.RESULTS: Of the 1831 subjects with COPD, 1779 completed the FACIT- F questionnaire. In adjusted cross-sectional analysis without depressive symptoms, higher perceived social support was associated with better quality of life, well-being, 6 minute walk distance, and less dyspnea. When also adjusting for depressive symptoms, all associations between social support and COPD outcomes were attenuated and no longer statistically significant. Mediation analysis suggested that depressive symptoms explained the majority (> = 85%) of the association between social support and measured COPD outcomes. Results of the longitudinal analysis were consistent with the cross-sectional analyses. There was no association between social support and odds of exacerbations.CONCLUSION: Higher social support was associated with better COPD outcomes across several measures of morbidity including quality of life, respiratory symptoms, and functional status. In addition, these associations were largely attenuated when accounting for depressive symptoms suggesting that the beneficial association of social support with COPD outcomes may be largely mediated by the association between social support and depression.TRIAL REGISTRATION: SPIROMICS was approved by Institutional Review Boards at each center and all participants provided written informed consent (clinicaltrials.gov: NCT01969344).

DOI10.1371/journal.pone.0245478
Alternate JournalPLoS One
PubMed ID33730034
PubMed Central IDPMC7968645
Grant ListK23 HL153672 / HL / NHLBI NIH HHS / United States
K24 HL137013 / HL / NHLBI NIH HHS / United States
U01 HL137880 / HL / NHLBI NIH HHS / United States
HHSN268200900013C / HL / NHLBI NIH HHS / United States
HHSN268200900014C / HL / NHLBI NIH HHS / United States
HHSN268200900015C / HL / NHLBI NIH HHS / United States
HHSN268200900016C / HL / NHLBI NIH HHS / United States
HHSN268200900017C / HL / NHLBI NIH HHS / United States
HHSN268200900018C / HL / NHLBI NIH HHS / United States
HHSN268200900019C / HL / NHLBI NIH HHS / United States
HHSN268200900020C / HL / NHLBI NIH HHS / United States
P50 MD010431 / MD / NIMHD NIH HHS / United States
R01 ES023500 / ES / NIEHS NIH HHS / United States
MS#: 
MS125
Manuscript Full Title: 
The influence of social support on COPD outcomes mediated by depression.
Manuscript Lead/Corresponding Author Affiliation: 
Clinical Center: Baltimore (Johns Hopkins University)
ECI: 
Manuscript Status: 
Published and Public