Relationship between depression and severity of COPD among Egyptian elderly patients

Background COPD is a multicomponent disease, and patients may have a very wide range of comorbid conditions that can affect prognosis and make a negative impact on morbidity and mortality [1]. Patients with COPD usually suffer from progressive reduction of lung function, decreased exercise capacity, frequent disease exacerbations, and development of extra-pulmonary comorbidities such as osteoporosis, cardiovascular diseases, and infections [2] with development of many other psychological troubles most commonly depression and anxiety [3] [4]. The prevalence of COPD in the elderly markedly increases with age and could reach up to 15% in those over 65 years [5]. Depression is one of the most important and most common comorbidities that may complicate COPD patients [6] with a reported prevalence of depression in patients with COPD ranges from 10–42%, which is much higher than in general population [7] [8], but it is often undiagnosed and undertreated [9]. The key pathophysiological mechanisms underlying the relationship between COPD and depression are not fully understood [10], but it occurs most probably due to systemic inflammation, perhaps via TNF-α, and oxidative stress [11], with many factors that contribute to depression in COPD such as socioeconomic status, female sex, and living alone [10]. Depressive disorders in COPD often present with moderate to severe symptoms leading to a decreased functional capacity [9] [12], marked poor health outcomes, lowered quality of life, significantly increased healthcare costs and increased mortality [6] [10]. Abstract