Associated factors and outcomes of social activity restriction in patients with chronic obstructive pulmonary disease: a real-world longitudinal cohort study.
8 affiliations
- 1Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China.
- 2National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, Hunan, China.
- 3Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, China.
- 4National Clinical Research Center for Geriatric Disease (Xiangya Hospital), Central South University, FuRong Laboratory, Changsha, Hunan, China.
- 5Department of Pulmonary and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
- 6Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, China.
- 7Clinical Medical Research Center for Pulmonary and Critical Care Medicine in Changsha, Hunan, China.
- 8Diagnosis and Treatment Center of Respiratory Disease in Hunan Province, Changsha, Hunan, China.
Abstract
Background
Social activity restriction has emerged as a new public health challenge; the factors associated with social activity restriction and its outcomes in patients with chronic obstructive pulmonary disease (COPD) are not yet clear. In this study, we aimed to describe the clinical characteristics of socially restricted COPD patients and to evaluate the effects of social activity restriction on acute exacerbation and mortality.Methods
We included participants enrolled in the RealDTC study between December 2016 and August 2020. We collected data on demographics, degree of social activity restriction, lung function, Clinical COPD Questionnaire score, and mortality at four years. We used multivariable regression analyses to examine whether restricted social activity was associated with the risks of acute exacerbation and mortality.Results
We included 3,679 patients in total. Their mean age was 65.72 (standard deviation = 9.1) years, and 11.3% had restricted social activities. Older age, widowhood, GOLD grades 3-4, Global Initiative for Chronic Obstructive Lung Disease groups B and D, history of acute exacerbation, COPD Assessment Test score of ≥10, and Modified Medical Research Council score of ≥2 were independently associated with social activity restriction. By multivariable analysis, patients with restricted social activities had higher risks of future acute exacerbation (adjusted odds ratio (aOR) = 1.320; 95% confidence interval (CI) = 1.100-1.583, P = 0.003) and severe acute exacerbation (aOR = 1.299; 95% CI = 1.014-1.664, P = 0.038). Furthermore, restricted social activity was an independent risk factor for mortality (hazard ratio = 1.752, 95% CI = 1.298-2.364, P < 0.001).Conclusions
Restricted social activity was not uncommon among patients with COPD. Social activity restriction should be routinely assessed in COPD clinics as a simple marker to identify patients at increased risk of exacerbation and mortality. During future epidemics or pandemics, public health responses should be more flexible, risk-stratified, and patient-centred for individuals with chronic respiratory disease. Future interventional and policy studies are needed to determine whether systematic assessment of social activity restriction and targeted supportive programs can improve outcomes in socially restricted patients with COPD.
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BibTeX
@article{liu2026associated,
title = {{Associated factors and outcomes of social activity restriction in patients with chronic obstructive pulmonary disease: a real-world longitudinal cohort study.}},
author = {Cong Liu and Zijing Zhou and Qing Song and Tao Li and Ping Zhang and Ling Lin and Yating Peng and Yuqin Zeng and Yan Chen and Shan Cai and Ping Chen},
journal = {Journal of global health},
year = {2026},
month = oct,
doi = {10.7189/jogh.16.04295},
url = {https://europepmc.org/article/MED/42924627},
note = {CC BY},
}
RIS
TY - JOUR
TI - Associated factors and outcomes of social activity restriction in patients with chronic obstructive pulmonary disease: a real-world longitudinal cohort study.
AU - Cong Liu
AU - Zijing Zhou
AU - Qing Song
AU - Tao Li
AU - Ping Zhang
AU - Ling Lin
AU - Yating Peng
AU - Yuqin Zeng
AU - Yan Chen
AU - Shan Cai
AU - Ping Chen
PY - 2026
DA - 2026/10/23
JO - Journal of global health
DO - 10.7189/jogh.16.04295
UR - https://europepmc.org/article/MED/42924627
AB - Background Social activity restriction has emerged as a new public health challenge; the factors associated with social activity restriction and its outcomes in patients with chronic obstructive pulmonary disease (COPD) are not yet clear. In this study, we aimed to describe the clinical characteristics of socially restricted COPD patients and to evaluate the effects of social activity restriction on acute exacerbation and mortality.Methods We included participants enrolled in the RealDTC study between December 2016 and August 2020. We collected data on demographics, degree of social activity restriction, lung function, Clinical COPD Questionnaire score, and mortality at four years. We used multivariable regression analyses to examine whether restricted social activity was associated with the risks of acute exacerbation and mortality.Results We included 3,679 patients in total. Their mean age was 65.72 (standard deviation = 9.1) years, and 11.3% had restricted social activities. Older age, widowhood, GOLD grades 3-4, Global Initiative for Chronic Obstructive Lung Disease groups B and D, history of acute exacerbation, COPD Assessment Test score of ≥10, and Modified Medical Research Council score of ≥2 were independently associated with social activity restriction. By multivariable analysis, patients with restricted social activities had higher risks of future acute exacerbation (adjusted odds ratio (aOR) = 1.320; 95% confidence interval (CI) = 1.100-1.583, P = 0.003) and severe acute exacerbation (aOR = 1.299; 95% CI = 1.014-1.664, P = 0.038). Furthermore, restricted social activity was an independent risk factor for mortality (hazard ratio = 1.752, 95% CI = 1.298-2.364, P < 0.001).Conclusions Restricted social activity was not uncommon among patients with COPD. Social activity restriction should be routinely assessed in COPD clinics as a simple marker to identify patients at increased risk of exacerbation and mortality. During future epidemics or pandemics, public health responses should be more flexible, risk-stratified, and patient-centred for individuals with chronic respiratory disease. Future interventional and policy studies are needed to determine whether systematic assessment of social activity restriction and targeted supportive programs can improve outcomes in socially restricted patients with COPD.
SN - 2047-2978
SN - 2047-2986
ER -