Higher levels of anxiety are associated with increased physical activity in patients with chronic obstructive pulmonary disease (COPD), US researchers report.
In a study of 148 COPD patients, the team found that Hospital Anxiety and Depression Scales-Anxiety (HADS-A) scores were positively and independently associated with total step count per day.
"However, it is unclear whether anxious COPD patients are more restless with increased psychomotor activity as a coping mechanism or whether those with COPD who push themselves to be more physically active experience more anxiety symptoms," comment lead author Huong Nguyen (Kaiser Permanente Southern California) and colleagues in Chest.
The participants (78% men), who had a mean 42% of predicted forced expiratory volume in 1 second and few co-morbidities, were assessed for daily step counts over a 7-day period and also completed the HADS-depression, as well as the HADS-A.
The researchers found that patients with clinically relevant anxiety levels (HADS-A >8) walked an average of 1681 more steps per day than those with lower levels of anxiety.
After accounting for factors such as age, gender, disease severity, functional capacity, depression, and dyspnea, each 1-point increase in HADS-A score was associated with a corresponding increase of 288 steps taken per day.
The team also found that increased levels of depression were associated with a lower number of steps taken per day, but anxiety attenuated the negative impact of depression on total step counts.
Nguyen et al conclude that "anxiety is associated with increased daily physical activity in a selected sample of patients with COPD."
They add: "The clinical implications of these observations are interesting because anxiety as a co-morbid disorder is associated with increased mortality while increased physical activity is associated with lower mortality in patients with COPD.
"Based on our results, future COPD studies should include objective measures of physical activity and systematic evaluations for anxiety to better inform how to improve the management and clinical outcomes of these patients."
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