Associated factors and outcomes of social activity restriction in patients with chronic obstructive pulmonary disease

A real-world longitudinal cohort study

Bibliographic Data

ID24242646
AuthorsCong Liu (0000-0001-8459-2637, Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China), Zijing Zhou (0000-0002-2729-1245, Central South University), Qing Song (0000-0002-1177-2562, Central South University), Tao Li (0000-0001-7895-4136, Central South University), Ping Zhang (0000-0003-0663-1850, Central South University), Ling Lin (0000-0001-6842-1408, Central South University), Yating Peng (0000-0003-2345-4059, Central South University), Yuqin Zeng (0000-0001-6599-3486, Central South University), Yan Chen (0000-0003-4119-9688, Central South University), Shan Cai (0000-0002-6876-5558, Central South University), Ping Chen (0000-0001-6707-8636, Central South University)
Year2026
Volume16
Pages04295-04295
Publication date2026-10-23
Open AccessYes
TypeARTICLE
VenueJournal of Global Health (JOURNAL)
Journal identifiersISSN: 2047-2978 • E-ISSN: 2047-2986
PublisherInternational Society of Global Health (PUBLISHER • GB)
DOI10.7189/jogh.16.04295
PMID42924627
OpenAlexW7223316395
LanguageEN
References cited37

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.

associated factors · chronic obstructive pulmonary disease · health outcomes · longitudinal cohort · Real world evidence · social activity restrictions · Social isolation · Asthma and respiratory diseases · Chronic Obstructive Pulmonary Disease (COPD) Research · Health disparities and outcomes