| 1. |
- Backman, Helena, et al.
(författare)
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Lung function trajectories and associated mortality among adults with and without airway obstruction
- 2023
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Ingår i: American Journal of Respiratory and Critical Care Medicine. - : American Thoracic Society. - 1073-449X .- 1535-4970. ; 208:10, s. 1063-1074
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Tidskriftsartikel (refereegranskat)abstract
- Rationale: Spirometry is essential for diagnosis and assessment of prognosis in COPD.Objectives: To identify FEV1 trajectories and their determinants, based on annual spirometry measurements among individuals with and without airway obstruction. Furthermore, to assess mortality in relation to trajectories.Methods: In 2002-04, individuals with airway obstruction (AO) (FEV1/VC<0.70, n=993) and age- and sex-matched non-obstructive (NO) referents were recruited from population-based cohorts. Annual spirometries until 2014 were utilized in joint-survival Latent Class Mixed Models to identify lung function trajectories. Mortality data were collected during 15 years of follow-up.Results: Three trajectories were identified among the AO-cases and two among the NO referents. Trajectory membership was driven by baseline FEV1%predicted (%pred) in both groups and additionaly, pack-years in AO and current smoking in NO. Longitudinal FEV1%pred level depended on baseline FEV1%pred, pack-years and obesity. The trajectories were distributed: 79.6% T1AO FEV1-high with normal decline, 12.8% T2AO FEV1-high with rapid decline, and 7.7% T3AO FEV1-low with normal decline (mean 27, 72 and 26 mL/year) among AO-individuals, and 96.7% T1NO FEV1-high with normal decline and 3.3% T2NO FEV1-high with rapid decline (mean 34 and 173 mL/year) among referents. Hazard for death was increased for T2AO (HR1.56) and T3AO (HR3.45) vs. T1AO, and for T2NO (HR2.99) vs. T1NO.Conclusions: Three different FEV1 trajectories were identified among those with airway obstruction and two among the referents, with different outcomes in terms of FEV1-decline and mortality. The FEV1 trajectories among airway obstructive and the relationship between low FVC and trajectory outcome are of particular clinical interest.
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| 2. |
- Eriksson, Berne, et al.
(författare)
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High prevalence of COPD among adults with heart disease
- 2019
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Ingår i: European Respiratory Journal. - Sheffield : European Respiratory Journal. - 0903-1936 .- 1399-3003. ; 54:suppl. 63
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 3. |
- Falk, Jimmy, et al.
(författare)
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Increased co-contraction reaction during a surface perturbation is associated with unsuccessful postural control among older adults
- 2022
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Ingår i: BMC Geriatrics. - : Springer Nature. - 1471-2318. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: As a strategy to maintain postural control, the stiffening strategy (agonist-antagonist co-contractions) is often considered dysfunctional and associated with poor physical capacity. The aim was to investigate whether increased stiffening is associated with unsuccessful postural control during an unpredictable surface perturbation, and which sensory and motor variables that explain postural stiffening.Methods: A sample of 34 older adults, 75.8 ± 3.8 years, was subjected to an unpredicted surface perturbation with the postural task to keep a feet-in-place strategy. The participants also completed a thorough sensory- and motor test protocol. During the surface perturbation, electromyography was measured from tibialis anterior and gastrocnemius to further calculate a co-contraction index during the feed-forward and feedback period. A binary logistic regression was done with the nominal variable, if the participant succeeded in the postural task or not, set as dependent variable and the co-contraction indexes set as independent variables. Further, the variables from the sensory and motor testing were set as independent variables in two separate Orthogonal Projections of Latent Structures (OPLS)-models, one with the feed-forward- and the other with the feedback co-contraction index as dependent variable.Results: Higher levels of ankle joint stiffening during the feedback, but not the feed-forward period was associated with postural task failure. Feedback stiffening was explained by having slow non-postural reaction times, poor leg muscle strength and being female whereas feed-forward stiffening was not explained by sensory and motor variables.Conclusions: When subjected to an unpredicted surface perturbation, individuals with higher feedback stiffening had poorer postural control outcome, which was explained by poorer physical capacity. The level of feed-forward stiffening prior the perturbation was not associated with postural control outcome nor the investigated sensory and motor variables. The intricate causal relationships between physical capacity, stiffening and postural task success remains subject for future research.
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| 4. |
- Falk, Jimmy, et al.
(författare)
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What Explains Successful or Unsuccessful Postural Adaptations to Repeated Surface Perturbations among Older Adults?
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 18:22
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Tidskriftsartikel (refereegranskat)abstract
- As we age there are natural physiological deteriorations that decrease the accuracy and flexibility of the postural control system, which increases the risk of falling. Studies have found that there are individual differences in the ability to learn to manage repeated postural threats. The aim of this study was to investigate which factors explain why some individuals are less proficient at adapting to recurrent postural perturbations. Thirty-five community dwelling older adults performed substantial sensory and motor testing and answered surveys regarding fall-related concerns and cognitive function. They were also subjected to three identical surface perturbations where both kinematics and electromyography was captured. Those that were able to adapt to the third perturbation were assigned to the group “Non-fallers” whereas those that fell during all perturbations were assigned to the group “Fallers”. The group designation dichotomized the sample in a hierarchical orthogonal projection of latent structures— the discriminant analysis model. We found that those who fell were older, had poorer physical performance, poorer strength and longer reaction times. The Fallers’ postural control strategies were more reliant on the stiffening strategy along with a more extended posture and they were less skillful at making appropriate feedforward adaptations prior to the third perturbation.
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| 5. |
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| 6. |
- Johansson Strandkvist, Viktor, et al.
(författare)
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Hand grip strength is associated with forced expiratory volume in 1 second among subjects with COPD : report from a population-based cohort study
- 2016
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Ingår i: The International Journal of Chronic Obstructive Pulmonary Disease. - : Dove Medical Press. - 1176-9106 .- 1178-2005. ; 11, s. 2527-2534
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cardiovascular diseases and skeletal muscle dysfunction are common comorbidities in COPD. Hand grip strength (HGS) is related to general muscle strength and is associated with cardiovascular disease and all-cause mortality, while the results from small selected COPD populations are contradictory. The aim of this population-based study was to compare HGS among the subjects with and without COPD, to evaluate HGS in relation to COPD severity, and to evaluate the impact of heart disease. Subjects and methods: Data were collected from the Obstructive Lung disease in Northern Sweden COPD study, where the subjects with and without COPD have been invited to annual examinations since 2005. In 2009-2010, 441 subjects with COPD (postbronchodilator forced expiratory volume in 1 second [FEV1]/vital capacity,0.70) and 570 without COPD participated in structured interviews, spirometry, and measurements of HGS. Results: The mean HGS was similar when comparing subjects with and without COPD, but those with heart disease had lower HGS than those without. When compared by Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades, the subjects with GOLD 3-4 had lower HGS than those without COPD in both sexes (females 21.4 kg vs 26.9 kg, P=0.010; males 41.5 kg vs 46.3 kg, P=0.038), and the difference persisted also when adjusted for confounders. Among the subjects with COPD, HGS was associated with FEV1% of predicted value but not heart disease when adjusted for height, age, sex, and smoking habits, and the pattern was similar among males and females. Conclusion: In this population-based study, the subjects with GOLD 3-4 had lower HGS than the subjects without COPD. Among those with COPD, HGS was associated with FEV1% of predicted value but not heart disease, and the pattern was similar in both sexes.
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| 7. |
- Johansson Strandkvist, Viktor, et al.
(författare)
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Impact of heart disease on hand grip strength in COPD: epidemiological data
- 2016
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Konferensbidrag (refereegranskat)abstract
- Background: Hand grip strength (HGS) and heart disease (HD) are related to mortality. Peripheral muscle dysfunction and HD are both frequently observed among subjects with COPD, but the relationship between HGS and HD in COPD is unclear.Aim: To evaluate HGS and the impact of HD among subjects with and without COPD.Methods: Data was collected from the OLIN (Obstructive Lung Disease in Northern Sweden) COPD study, where subjects with COPD have been invited to annual examinations since 2005 together with age- and sex-matched subjects without COPD. During 2009, 441 subjects with COPD and 570 without COPD participated in examinations including structured interviews, spirometry and measurements of HGS. COPD was defined as post-bronchodilator FEV1/VC<0.70.Results: Both among subjects with and without COPD, and in both sexes, those with HD had significantly lower HGS. The proportion of subjects below estimated normal value for HGS was similar in subjects with and without COPD and in both sexes; among women (35.4 vs. 33.4%, p=0.714) and men (19.1 vs 15.9%, p=0.315). In a linear regression model among subjects with COPD only, HGS was significantly associated with age, beta coefficient (B) = -0.46 (p<0.001), sex, B=19.85 (p<0.001) and FEV1 % of predicted normal value, B=0.06 (p=0.007), but not with HD or smoking habits. When a similar model was estimated among subjects without COPD, HGS was only associated with age and sex.Conclusions: In this population-based study, subjects with heart disease had lower hand grip strength regardless if they had COPD or not. Among COPD subjects, hand grip strength was associated with age, sex and FEV1, but not with heart disease.
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| 8. |
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| 9. |
- Lindberg, Anne, et al.
(författare)
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From COPD epidemiology to studies of pathophysiological disease mechanisms : challenges with regard to study design and recruitment process
- 2017
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Ingår i: European Clinical Respiratory Journal. - : Taylor & Francis. - 2001-8525. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic obstructive pulmonary disease (COPD) is a largely underdiagnosed disease including several phenotypes. In this report, the design of a study intending to evaluate the pathophysiological mechanism in COPD in relation to the specific phenotypes non-rapid and rapid decline in lung function is described together with the recruitment process of the study population derived from a population based study.Method: The OLIN COPD study includes a population-based COPD cohort and referents without COPD identified in 2002–04 (n = 1986), and thereafter followed annually since 2005. Lung function decline was estimated from baseline in 2002–2004 to 2010 (first recruitment phase) or to 2012/2013 (second recruitment phase). Individuals who met the predefined criteria for the following four groups were identified; group A) COPD grade 2–3 with rapid decline in FEV1 and group B) COPD grade 2–3 without rapid decline in FEV1 (≥60 and ≤30 ml/year, respectively), group C) ever-smokers, and group D) non-smokers with normal lung function. Groups A–C included ever-smokers with >10 pack years. The intention was to recruit 15 subjects in each of the groups A-D.Results: From the database groups A–D were identified; group A n = 37, group B n = 29, group C n = 41, and group D n = 55. Fifteen subjects were recruited from groups C and D, while this goal was not reached in the groups A (n = 12) and B (n = 10). The most common reasons for excluding individuals identified as A or B were comorbidities contraindicating bronchoscopy, or inflammatory diseases/immune suppressive medication expected to affect the outcome.Conclusion: The study is expected to generate important results regarding pathophysiological mechanisms associated with rate of decline in lung function among subjects with COPD and the in-detail described recruitment process, including reasons for non-participation, is a strength when interpreting the results in forthcoming studies.
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| 10. |
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| 11. |
- Pauelsen, Mascha, et al.
(författare)
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Frequency domain shows : Fall-related concerns and sensorimotor decline explain inability to adjust postural control strategy in older adults
- 2020
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Ingår i: PLOS ONE. - : PLOS. - 1932-6203. ; 15:11
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Tidskriftsartikel (refereegranskat)abstract
- Human postural control is a complex system and changes as we age. Frequency based analyses have been argued to be useful to identify altered postural control strategies in balance tasks. The aim of this study was to explore the frequency domain of the quiet stance centre of pressure of older adults with various degrees of fall-related concerns and sensorimotor functioning. We included 45 community dwelling older adults and used a force plate to register 30 seconds of quiet stance with eyes open and closed respectively. We also measured sensory and motor functions, as well as fall-related concerns and morale. We analysed the centre of pressure power spectrum density and extracted the frequency of 4 of its features for each participant. Orthogonal projection of latent structures–discriminant analysis revealed two groups for each quiet stance trial. Group 1 of each trial showed less sensory and motor decline, low/no fall-related concerns and higher frequencies. Group 2 showed more decline, higher fall-related concerns and lower frequencies. During the closed eyes trial, group 1 and group 2 shifted their features to higher frequencies, but only group 1 did so in any significant way. Higher fall-related concerns, sensory and motor decline, and explorative balancing strategies are highly correlated. The control system of individuals experiencing this seems to be highly dependent on vision. Higher fall-related concerns, and sensory and motor decline are also correlated with the inability to adjust to faster, more reactive balancing strategies, when vision is not available.
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| 12. |
- Strandkvist, Viktor
(författare)
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Hand grip strength and postural control among individuals with and without Chronic Obstructive Pulmonary Disease : Epidemiological and motion laboratory studies
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundChronic obstructive pulmonary disease (COPD) is estimated to affect approximately 8%–10% of all adults. The disease is considered to be a heterogenic syndrome with systemic effects, in which comorbidities including cardiovascular diseases, muscle dysfunction and fatigue are common. The majority of all individuals with COPD have mild to moderate disease (Global Initiative for Chronic Obstructive Lung Disease (GOLD) 1-2), and only a third are identified by health care, and this under-diagnosis contributes to a lack of knowledge of COPD in the population. COPD is related to skeletal muscle dysfunction, where muscle weakness, frequently assessed with hand grip strength (HGS), is one of the components. Evidence of postural control limitations among individuals with severe or very severe COPD has been emerging during the last decade. These limitations are partly related to muscle weakness, however, research of the other underlying systems of postural control is scarce, and an increased knowledge is of importance for the prevention of falls.AimThe main objective of the thesis was to increase the population-based knowledge about muscle strength, assessed as hand grip strength, and also postural control among individuals with and without COPD. Another objective was to investigate the value of hand grip strength measurements in relation to lower limb muscle strength and postural control among community-dwelling older adults.MethodsPaper I and II are based on the population-based Obstructive Lung disease in Northern Sweden (OLIN) COPD study. All individuals with obstructive lung function impairment (n=993) and an age- and sex-matched group without (n=993) (COPD and non-COPD) were identified after re-examination of population based cohorts during 2002-04. They (n=1,986) have been invited to recurrent examinations including structured interviews and spirometry. Paper I (n=1011) and II (n=831) include data from examinations during 2009-2010 and 2014, respectively, where measurements of HGS (Paper I & II) as well as assessment of fatigue and physical activity (Paper II) were included. Paper III and IV are based on the population-based Balancing Human and Robot (BAHRT) study. Randomly selected individuals over 70 years of age were invited to participate in a study of postural control aspects, in their homes and at the 2 Human Health and Performance Lab- Movement Science, at Luleå University of Technology. The examinations included a structured interview as well as measurements of postural control and sensory and motor systems including HGS, lower limb strength, proprioception, pressure sensitivity, visual acuity, vestibular function and reaction time. Participants in Paper III consisted of communitydwelling individuals over 70 years of age (n=45). Paper IV consisted of individuals with COPD recruited from both the OLIN COPD study as well as the BAHRT-study (n=22), as well as a control group without airway obstruction from the BAHRT-study (n=34).ResultsIn Paper I, there was no differences in mean HGS between the groups with and without COPD. However, HGS was related to disease severity; HGS was lower among those with severe to very severe COPD (GOLD 3-4) compared to nonCOPD, and HGS was associated with forced expiratory volume during 1 second % of predicted value (FEV1 % predicted) in regression models. Five years later, in Paper II, mean HGS was lower in COPD compared to non-COPD. Further, individuals with COPD and clinically relevant fatigue had lower HGS than those without clinically relevant fatigue, significantly so among men and close to among women. There was no clear association between HGS and level of physical activity. In Paper III, there was a strong and valid model showing association between HGS and lower limb strength, where all tested muscle groups were significantly correlated to hand grip strength. The regression model with HGS and postural control was significant, however, the model was weak. In Paper IV, individuals with COPD had worse postural control than those without COPD, significantly so regarding mediolateral amplitude in quiet stance with eyes open on soft/unstable surface, as well as anteroposterior limits of stability. In the COPD group, mediolateral amplitude was related to eye sight and the burden of tobacco smoking assessed as pack-years. Further, muscle strength associated with anteroposterior amplitude in the limits of stability test.ConclusionsIn the population-based OLIN COPD study in 2009-2010, mean HGS was significantly lower among individuals with severe to very severe COPD (GOLD 3-4) than those without COPD. Five years later, mean HGS was lower among all individuals with COPD (GOLD 1-4) compared to those without COPD, which may indicate altered aging process in COPD. HGS was associated to fatigue among individuals with COPD, while there were no associations between HGS and physical activity. HGS is a valid tool for the estimation of lower limb muscle strength among community-dwelling older adults, however, HGS is not 3 appropriate to use as an estimation of postural control. Postural control was impaired among individuals with COPD and different postural control assessments had different demands on the sensory and motor systems. The burden of tobacco smoking and visual acuity might be important for quiet stance trials with visual input, while muscle strength might be important for the more dynamic limits of stability test. Further research regarding the longitudinal aspects of muscle weakness and postural control among individuals with COPD is needed to gain knowledge for appropriate preventive or rehabilitative interventions.
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| 13. |
- Strandkvist, Viktor, et al.
(författare)
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Hand grip strength is associated with fatigue among men with COPD : epidemiological data from northern Sweden
- 2020
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Ingår i: Physiotherapy Theory and Practice. - : Taylor & Francis. - 0959-3985 .- 1532-5040. ; 36:3, s. 408-416
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate if hand grip strength (HGS) is associated with: 1) fatigue, and specifically clinically relevant fatigue (CRF); 2) low physical activity; and 3) fatigue independent of physical activity level, among individuals with and without COPD. Data were collected from the Obstructive Lung Disease in Northern Sweden (OLIN) COPD-study in 2014. HGS was measured with a hand-grip dynamometer, fatigue and physical activity were assessed by questionnaires; FACIT-Fatigue respectively IPAQ. Among individuals with COPD (n = 389), but not without COPD (n = 442), HGS was lower among those with CRF than those without CRF, significantly so among men (p = 0.001) and close to among women (p = 0.051). HGS was not associated with physical activity levels within any of the groups. HGS was associated with fatigue among men, but not women, with COPD independent of physical activity level, age, height, and smoking habits (Beta = 0.190, 95% CI 0.061-0.319, respectively Beta = 0.048, 95% CI-0.056-0.152), while there were no corresponding significant findings among individuals without COPD. In summary, HGS was associated with CRF among individuals with COPD in this population-based study. Among men with COPD, HGS was associated with fatigue independent of physical activity level and common confounders.
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| 14. |
- Strandkvist, Viktor, et al.
(författare)
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Hand grip strength is strongly associated with lower limb strength but only weakly with postural control in community-dwelling older adults
- 2021
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier. - 0167-4943 .- 1872-6976. ; 94
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Tidskriftsartikel (refereegranskat)abstract
- Background:Hand grip strength is frequently used as a measurement of muscle strength, especially among older adults. Muscle strength is only one of the many components in postural control and it is currently unclear to what extent hand grip strength is associated with postural control. The aim was to analyze the association between hand grip strength and lower limb muscle strength, and postural control among older adults.Methods:Forty-five community-dwelling individuals over 70 years of age provided isometric hand grip strength and lower limb strength (including hip extension and abduction, knee flexion and extension, and ankle dorsiflexion and plantarflexion), as well as postural control measurements. In the latter, center of pressure excursions were recorded for quiet stance and limits of stability tests on a force plate. Orthogonal projection of latent structures regression models were used to analyze associations between hand grip strength and lower limb strength as well as postural control, respectively.Results:Lower limb strength explained 74.4% of the variance in hand grip strength. All lower limb muscle groups were significantly associated with hand grip strength. In a corresponding model, postural control measured with center of pressure excursions explained 20.7% of the variance in a statistically significant, albeit weak, model.Conclusions:These results support that hand grip strength is a valid method to estimate lower limb strength among older adults on a group level. However, strength measurements seem insufficient as a substitute for measuring postural control, and therefore specific balance tests are necessary.
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| 15. |
- Strandkvist, Viktor, et al.
(författare)
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Hand muscle strength in COPD : A population based study
- 2013
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Ingår i: European Respiratory Journal. - 0903-1936 .- 1399-3003. ; 42:Suppl 57
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Tidskriftsartikel (refereegranskat)abstract
- Background: Skeletal muscle dysfunction is a known systemic- or extra pulmonary effect in COPD. The relationship between the severity of the disease according to GOLD’s spirometric criteria and muscle dysfunction is however not clearly explored.Aim: To investigate hand grip strength (HGS) in subjects with COPD compared to subjects without airflow obstruction.Method: Lung function and HGS was measured according to validated methods in the years of 2009-2010 within the Obstructive Lung Disease in Northern Sweden (OLIN) COPD-study. HGS, was measured with a hand-held dynamometer (Jamar®) in kilogram-strength (kgf), which has been shown to correlate strongly with both upper- and lower extremity strength. The sample included 441 subjects with COPD according to GOLD criteria (FEV1/FVC<0.70) and 571 non-COPD subjects in the same ages.Results: Among men, HGS was lower in GOLD III-IV, mean=31.4 kgf, compared to GOLD II, mean=37.2 kgf (p=0.009), GOLD I, mean=36.9 kgf (p=0.024), and subjects without COPD, mean=37.6 kgf (p=0.024). Among women no such correlation was found. In the whole sample, HGS, did not differ significantly between subjects with and without COPD, or COPD stages according to GOLD. No correlation was found between percent predicted FEV1 but a strong and positive relationship was found between the crude value of FEV1 and HGS (pearson's r=0.67).Conclusion: Among men, GOLD III-IV was associated with a lower HGS, however not among women.
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| 16. |
- Strandkvist, Viktor, et al.
(författare)
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Postural control among individuals with and without chronic obstructive pulmonary disease: A cross-sectional study of motor and sensory systems
- 2023
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 18:4
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundChronic obstructive pulmonary disease (COPD) is considered a heterogenic syndrome with systemic effects, including muscle dysfunction. There is evidence of postural control impairments among individuals with COPD, partly related to muscle weakness. However, research is scarce regarding the other underlying systems of postural control, such as the visual, somatosensory and vestibular system. The aim was to compare postural control, as well as the motor and sensory systems, between individuals with and without COPD.MethodsTwenty-two participants with COPD (mean age 74.0 ±6.2 years) and 34 non-obstructive references (mean age 74.9 ±4.9 years) participated in this cross-sectional study. Postural control was assessed with center of pressure trajectory of postural sway in quiet as well as a limits of stability test, calculating mediolateral and anteroposterior amplitudes for each test. Assessment of function in the motor system included maximum hand grip strength, as well as maximum strength in muscles around the hip, knee and ankle joints. Visual acuity, pressure sensibility, proprioception, vestibular screening, and reaction time were also included. Data was compared between groups, and significant differences in postural control were further analyzed with an orthogonal projection of latent structures regression model.ResultsThere was a significantly increased sway amplitude in the mediolateral direction in quiet stance on soft surface with eyes open (p = 0.014) as well as a smaller anteroposterior amplitude in the limits of stability test (p = 0.019) in the COPD group. Regression models revealed that the mediolateral amplitude was related to visual acuity and the burden of tobacco smoking assessed as pack-years. Further, muscle strength associated with anteroposterior amplitude in limits of stability test in the COPD group, and with age and ankle dorsal flexion strength among the referents. Besides for lower ankle plantar flexion strength in the COPD group, there were however no significant differences in muscle strength.ConclusionsIndividuals with COPD had a decreased postural control and several factors were associated with the impairments. The findings imply that the burden of tobacco smoking and reduced visual acuity relate to increased postural sway in quiet stance, and that muscle weakness is related to decreased limits of stability, among individuals with COPD.
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| 17. |
- Stridsman, Caroline, et al.
(författare)
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The COPD Assessment Test (CAT) can screen for fatigue among patients with COPD
- 2018
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Ingår i: Therapeutic Advances in Respiratory Disease. - : Sage Publications. - 1753-4658 .- 1753-4666. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Background:Fatigue is one of the most common symptoms among subjects with chronic obstructive pulmonary disease (COPD), but is rarely identified in clinical practice. The aim of this study was to evaluate the association between fatigue and health-related quality of life (HRQoL) assessed with clinically useful instruments, both among subjects with and without COPD. Further, to investigate the association between fatigue and the COPD Assessment Test (CAT)-energy question.Methods:Data were collected in 2014 within the population-based OLIN COPD study. Subjects with (n = 367) and without (n = 428) COPD participated in clinical examinations including spirometry and completed questionnaires about fatigue (FACIT-Fatigue, clinically relevant fatigue ⩽43), and HRQoL (EQ-5D-VAS, lower score = worse health; CAT, lower score = fewer symptoms/better health).Results:Subjects with clinically relevant fatigue had worse HRQoL measured with EQ-5D-VAS, regardless of having COPD or not. Decreasing EQ-5D-VAS scores, any respiratory symptoms and anxiety/depression were associated with clinically relevant fatigue also when adjusted for confounders. Among subjects with COPD, clinically relevant fatigue was associated with increasing total CAT score, and CAT score ⩾10. The proportion of subjects with clinically relevant fatigue increased significantly, with a higher score on the CAT-energy question, and nearly 50% of those with a score of 2, and 70% of those with a score of ⩾3, had clinically relevant fatigue.Conclusions:Fatigue was associated with respiratory symptoms, anxiety/depression and worse HRQoL when using the clinically useful instruments EQ-5D-VAS and CAT. The CAT-energy question can be used to screen for fatigue in clinical practice, using a cut-off of ⩾2.
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