Overly short daily walks and weak legs, mental distress, and systemic inflammation considerably impact quality of life in people with bronchiectasis and severe asthma, a study suggests.
“Extrapulmonary associations of health status in severe asthma and bronchiectasis: Comorbidities and functional outcomes” was published in the journal Respiratory Medicine.
Bronchiectasis and severe asthma are known to affect much more than a person’s airways, but life quality is rarely studied.
Researchers explored health-related but non-pulmonary traits for their impact on quality of life in adults with bronchiectasis (61 people) and severe asthma (70 people).
Specifically, they looked at physical activity (measured by number of steps per day), mental health (namely, anxiety and depression), isometric leg strength (leg muscle contraction in a static position, or without moving the joints; stronger muscles produce more force), systemic inflammation, and the presence of other diseases (comorbidities).
Health-related quality of life was assessed using the St. George’s Respiratory Questionnaire (SGRQ), a self-reported questionnaire specific to people with chronic airway diseases.
SGRO includes 50 questions divided among three topics: symptoms (frequency and severity), activity limitations due to breathlessness, and social and emotional impacts. Answers to each section are weighted according to the associated distress. Final scores range from 0 to 100, with higher scores corresponding to a poorer quality of life.
A difference equal or above four points in the SGRQ is considered to be clinically relevant.
Results showed that bronchiectasis and severe asthma patients had similar mean scores in the SGRQ questionnaire, 37.8 and 43.7, respectively.
Moreover, the traits studied had a similar negative impact in both groups. “The associations between extrapulmonary variables and HRQoL [health-related quality of life] did not differ according to diagnosis,” the researchers wrote.
Anxiety and depression, along with low physical activity (less than 4,125 steps daily), and whole body inflammation were parameters associated with worse quality of life in both bronchiectasis and severe asthma patients.
Of note, the minimum physical activity linked to a better quality of life was 7,000 steps a day.
“Our findings indicate that more than 7000 steps/day may be the level of physical activity associated with clinically significant improvements in HRQoL [health-related quality of life], and thus it could be considered an activity target,” the researchers wrote.
Lower isometric leg strength in severe asthma patients and a higher score in the Charlson Comorbidity Index in bronchiectasis patients were also associated with a poorer health-related quality of life.
Overall, “decreased physical activity, anxiety and depression, leg strength and systemic inflammation are shared extrapulmonary characteristics that are independently associated with HRQoL [health-related quality of life] in severe asthma and bronchiectasis, especially within the activity and impact domains,” the team concluded.
According to the researchers, these traits should be considered when patients are being evaluated, as they may be promising targets for intervention to improve life quality.