Physical activity and quality of life in subjects with chronic disease: Chronic obstructive pulmonary disease compared with rheumatoid arthritis and diabetes mellitus

Figures & data

Figure 1.  Selection of the population surveyed. “Only” indicates that the index disease does not include any of the other diseases. Note: COPD = chronic obstructive pulmonary disease, RA = rheumatoid arthritis, DM = diabetes mellitus.

Table I.  Characteristics of the study population aged 40–84 years (n = 10 755).

	Diseases
	COPD n =526	RA n =1 120	DM n =2 149	Healthy n =6 960
Age, yrs	69.1 (68.3–69.9)	65.4 (64.7–66.1)	67.5 (67.1–68.0)	58.0 (57.7–58.3)
Sex, females (%)	44.3 (40.0–48.9)	64.8 (62.0–67.6)	42.8 (40.7–44.9)	52.7 (51.5–53.9)
BMI (kg/m^2)	25.4 (25.1–25.8)	26.2 (26.0–26.5)	28.3 (28.1–28.6)	25.3 (25.2–25.4)
Smoking status (%)
Never smokers	12.1 (9.3–15.0)	45.3 (42.4–48.3)	46.8 (44.7–49.0)	52.5 (51.4–53.7)
Ex-smokers	53.0 (48.7–57.4)	31.1 (28.3–33.8)	39.3 (37.3–41.4)	27.3 (26.2–28.3)
Current smokers	34.8 (30.7–39.0)	23.6 (21.1–26.1)	13.8 (12.3–15.3)	20.2 (19.2–21.1)
Highest educational level (%)
Compulsory school	68.7 (64.7–72.8)	56.3 (53.3–59.3)	63.0 (60.9–65.1)	38.7 (37.5–39.8)
Grammar school	12.0 (9.2–14.9)	20.8 (18.3–23.2)	16.0 (14.4–17.6)	29.8 (28.7–30.9)
University	12.2 (9.3–15.1)	14.6 (12.5–16.7)	12.5 (11.1–13.9)	25.9 (24.8–27.0)
Other	7.0 (4.8–9.3)	8.3 (6.7–10.0)	8.4 (7.2–9.6)	5.6 (5.1–6.2)
Employment (%)
Employed or studying	19.0 (15.6–22.4)	27.1 (24.4–29.7)	26.2 (24.3–28.1)	66.6 (65.5–67.8)
Sick leave or sickness pension	13.5 (10.6–16.4)	18.7 (16.5–21.0)	10.7 (9.4–12.0)	1.7 (1.4–2.0)
Retired	66.7 (62.7–70.8)	52.9 (50.0–55.9)	59.7 (57.7–61.8)	28.0 (27.0–29.1)
Economic problems (%)	15.6 (12.4–18.7)	15.4 (13.3–17.6)	9.5 (8.3–10.8)	7.9 (7.2–8.5)
Living alone (%)	36.3 (32.2–40.4)	29.3 (26.6–32.0)	26.7 (24.8–28.5)	17.3 (16.4–18.2)

Notes: Data are presented as percentage or mean with 95% confidence intervals in parentheses. COPD = chronic obstructive pulmonary disease (not RA, not DM), RA = rheumatoid arthritis (not COPD, not DM), DM = diabetes mellitus (not COPD, not RA), Healthy = subjects with no diseases or impairments, BMI = Body mass index.

Table II.  Physical activity level (n = 10 755).

	Diseases
	COPD n = 526	RA n = 1120	DM n = 2149	Healthy n = 6960
High activity level^1	15.8	25.6	27.5	39.8
Low activity level^2	84.2	74.4	72.5	60.2
OR^3 (95% CI)	1	1.80 (1.33–2.45)	2.17 (1.63–2.90)	2.49 (1.88–3.28)

Notes: Data are presented as percentage with odds ratio and 95% confidence intervals within parentheses. COPD = chronic obstructive pulmonary disease, RA = rheumatoid arthritis, DM = diabetes mellitus, OR = odds ratio, CI = confidence interval. ¹Moderate regular exercise (high activity >30 minutes, 1–2 times a week) or regular exercise and training (high activity >30 minutes ≥3 times a week), ²sedentary lifestyle (mostly sitting down or low activity <2 hours a week) or moderate exercise (low activity >2 hours a week). ³The adjusted odds ratio expresses the likeliness of higher activity level in the non-COPD groups compared with the COPD group after adjusting for sex, age, smoking, BMI, educational level, employment status, economic problems, and living alone.

Table III.  The EQ-5D index and percentages of subjects reporting any problems (moderate or severe problems) in different dimensions of the EQ-5D (n = 10 755).

	Diseases
	COPD n = 526	RA n = 1120	DM n = 2149	Healthy n = 6960
EQ-5D index value, mean (SD)	0.62 (0.27)	0.60 (0.27)	0.72 (0.25)	0.91 (0.12)
Present state of health (EQ-5D), any problems
Mobility	48.4	55.3	36.1	3.6
OR^1 (95% CI)	1	1.75 (1.37–2.22)	0.63 (0.50–0.79)	0.10 (0.07–0.12)
Self-care	9.1	12.1	7.2	0.3
OR^1 (95% CI)	1	1.49 (0.98–2.22)	0.84 (0.56–1.27)	0.07 (0.04–0.13)
Usual activities	38.5	38.0	23.4	0.9
OR^1 (95% CI)	1	0.93 (0.72–1.20)	0.48 (0.38–0.62)	0.03 (0.02–0.04)
Pain/Discomfort	87.3	96.1	74.8	34.8
OR^1 (95% CI)	1	3.85 (2.50–5.88)	0.43 (0.32–0.58)	0.11 (0.08–0.14)
Anxiety/Depression	52.6	47.4	34.9	15.5
OR^1 (95% CI)	1	0.64 (0.50–0.81)	0.47 (0.38–0.59)	0.18 (0.14–0.22)

Notes: Data are presented as mean and standard deviation (SD) or percentage with odds ratio and 95% confidence intervals within parentheses. EQ-5D = the EuroQol five-dimension questionnaire, COPD = chronic obstructive pulmonary disease, RA = rheumatoid arthritis, DM = diabetes mellitus, OR = odds ratio, CI = confidence interval. ¹The adjusted odds ratio expresses the likeliness of reporting a problem in the non-COPD groups compared with the COPD group after adjusting for sex, age, smoking, BMI, educational level, employment status, economic problems, and living alone.

Table IV.  Impaired psychological well-being, symptoms past three months, and personal future view (n = 10 755).

	Diseases
	COPD n = 526	RA n = 1120	DM n = 2149	Healthy n = 6960
GHQ12
Impaired well-being (score ≥ 3)	23.3	22.6	13.3	6.8
OR^1 (95% CI)	1	0.71 (0.54–0.94)	0.48 (0.36–0.63)	0.18 (0.14–0.24)
Symptoms past three months
Anxiety and worry
Many occasions/all the time	26.3	23.3	13.7	5.9
OR^1 (95% CI)	1	0.61 (0.46–0.81)	0.48 (0.36–0.63)	0.17 (0.13–0.23)
Fatigue
Many occasions/all the time	49.6	51.7	31.9	8.4
OR^1 (95% CI)	1	0.91 (0.71–1.16)	0.49 (0.39–0.61)	0.10 (0.08–0.13)
Sleeping problems
Many occasions/all the time	35.8	41.5	24.5	10.5
OR^1 (95% CI)	1	1.12 (0.88–1.43)	0.66 (0.52–0.84)	0.26 (0.21–0.33)
Depression
Many occasions/all the time	26.1	21.8	12.7	4.0
OR^1 (95% CI)	1	0.59 (0.44–0.78)	0.46 (0.35–0.61)	0.13 (0.10–0.18)
“Personal opinion on your future”
Pessimistic	19.8	12.1	8.3	2.1
OR^1 (95% CI)	1	0.47 (0.32–0.68)	0.36 (0.25–0.51)	0.09 (0.06–0.12)

Notes: Data are presented as percentage with odds ratio and 95% confidence intervals within parentheses. COPD = chronic obstructive pulmonary disease, RA = rheumatoid arthritis, DM = diabetes mellitus, GHQ12 = General Health Questionnaire 12-item version, OR = odds ratio, CI = confidence interval. ¹The adjusted odds ratio expresses the likeliness of reporting a problem in the non-COPD groups compared with the COPD group after adjusting for sex, age, smoking, BMI, educational level, employment status, economic problems, and living alone.