A75-23 Association of Anxiety and Depression With Dyspnea and Physical Activity in Fibrotic Interstitial Lung Disease

Background

Anxiety and depression have been reported in patients with fibrotic interstitial lung disease (f-ILD) and may be detected or evaluated with use of patient reported outcome measures (PROMs). The Generalized Anxiety Disorder-7 (GAD-7) is a screening tool for general anxiety, and the Patient Health Questionnaire (PHQ-9) is a screening tool for depression. We hypothesize that anxiety and depression in f-ILD may be independently associated with increased self-reported dyspnea and decreased physical activity.

Methods

This was a prospective observational cohort study conducted at a tertiary care institution. Patients with f-ILD were electronically sent PROMs to be completed at study enrollment, three months and six months. Patients also wore an activity monitor (ActiGraph) for 7 days at each time point. Included PROMs were the Modified Medical Research Council dyspnea scale (mMRC), GAD-7, and PHQ-9. The primary outcome was physical activity defined by average steps per day at each timepoint. Two sided, two sample t- tests were used to compare mean mMRC scores between participants with and without anxiety and depression. Mixed effects linear regression models with each patient as a random effect were used to evaluate the association between PROMS and physical activity. Models were adjusted for age, sex, FVC, and timepoint.

Results

Forty-eight patients were enrolled (mean age 69, female 46%, mean forced vital capacity (FVC%) 80%) and 45 completed baseline PROM and activity measures. In our cohort, 22 (46%) had background clinical anxiety and 17 (31%) had depression. In those with anxiety, 59% were classified as moderate and 2% as severe, while 47% were classified as moderate and 1% as severe in those with depression. Higher mMRC dyspnea scores were associated with both anxiety (1.955, p = 0.058) and depression (2.118, p = 0.022). Results from regression models indicated a one-point increase in GAD7, PHQ-9, and mMRC was associated with decrease in physical activity as defined by steps per day) ([GAD: -272 steps, p = 0.022], [PHQ-9: -188 steps, p = 0.014], [mMRC: -741 steps, p = 0.007]).

Conclusions

Patients with f-ILD and clinical anxiety and depression reported greater dyspnea and decreased measured physical activity.

This abstract is funded by: None