Effects of the Combination of Pulmonary Rehabilitation and Cognitive Behavior Therapy on Depression in Elder Patients with Chronic Obstructive Pulmonary Disease

<bold>Methods:</bold> This Prospective Cohort study initially recruited 84 elderly COPD patients from Tianjin Medical University General Hospital. After exclusions, 41 inpatients (≥65 years) with stable COPD were analyzed, categorized into a control group (n=20) and an experimental group (n=21). The control group was subjected to CCBT concomitant with the standard treatment regimen for COPD, while the experimental group was administered an additional 8-week PR program built upon the standard treatment. Baseline characteristics, age, sex, smoking status, COPD severity, disease duration, and body mass index (BMI) were recorded for each patient. The forced expiratory volume in one-second percentage of predicted (FEV1%pred) and the 17-item Hamilton Rating Scale for Depression (HAMD-17) was assessed at the onset of treatment, two weeks into the treatment, and two months into the treatment (completing a full treatment cycle). Meanwhile, the HAMD-17 was evaluated at a two-month post-treatment follow-up. Analysis was conducted using linear mixed effects models. <bold>Results:</bold> The combination of PR and CCBT resulted in a significant reduction of HAMD-17 scores in participants at 2-month post-treatment follow-up (P=0.002) as well as improvement in FEV1%pred at post-treatment (P=0.002) compared with those receiving CCBT alone. <bold>Conclusion:</bold> Our findings suggest that elderly patients with stable COPD receiving PR in combination with CCBT demonstrated more substantial improvements in both depression and lung function compared to those who received CCBT alone.