Presence of in-home caregiver and health outcomes of older adults with chronic obstructive pulmonary disease

Objectives: To determine whether the presence of in-home caregivers is associated with changes in the health outcomes of older adults with chronic obstructive pulmonary disease (COPD).

Design: Cross-sectional study.

Setting: Geriatric medical center and academic respiratory clinic in Japan.

Participants: Community-dwelling adults with COPD and their caregivers.

Measurements: Outcome measures (pulmonary function tests, distance on the 6-minute walking test (6MWT), activities of daily living (ADLs), quality of life (Medical Outcomes Study 36-item Short Form Survey and St. George's Respiratory Questionnaire), and frequencies of emergency visits and hospitalizations of those living alone (group A), those living with one caregiver (group B), and those living with two or more caregivers (group C) were compared.

Results: Three hundred eighty-nine participants (315 men and 74 women; mean age 73.3) were enrolled. Mean predicted forced expiratory volume in 1 second was 57.5%. The numbers of participants allocated into the global initiative for chronic obstructive lung disease stages I, II, III, and IV were 105, 107, 122, and 55, respectively. Group A had 87 participants; group B, 125; and group C, 177. Instrumental ADL scores were highest in group A (P < .001), whereas 6MWT distance was longest in group B and shortest in group A. The frequency of emergency visits was highest in group A (P < .001).

Conclusion: Participants with COPD living alone were higher functioning in terms of instrumental ADLs, but they had less exercise capacity and more-frequent emergency visits than participants in the in-home caregiver groups and no difference in hospitalizations.