Impacts of baseline anxiety and depression on acceleration of lung function impairment in elderly population: Results of LEAD cohort study

<bold>Background:</bold> Lung function impairment serves as a robust predictor of both survival and functional limitations. <bold>Objectives:</bold> This study aim to assess the effects of anxiety and depression on the rate of decline in spirometry indices in the elderly population. <bold>Methods:</bold> The study included participants aged ≥60 at visit 1 and attending visit 2 (N=2113) of the Lung hEart sociAl boDy (LEAD) cohort. All participants completed the Hospital Anxiety and Depression Scale (HADS), with scores greater than 10 considered abnormal. A mixed-effect linear regression was conducted, with anxiety and depressive symptoms at baseline as independent factors and the percentage of change in FEV1 and FVC during the 4-year follow-up as the dependent variable. <bold>Results:</bold> At visit 1, 105 (5.0%) and 57 (2.7%) participants were diagnosed as anxious and depressed, respectively. Anxious participants lost 149 ml (6.2%) of FEV1 and 133 ml (4.0%) of FVC, compared to 111 ml (3.9%) and 53 ml (1.2%) for non-anxious participants. Depressed participants lost 115 ml (4.5%) of FEV1 and 81 ml (2.5%) of FVC, compared to112 ml (4.0%) and 56 ml (1.3%) for non-depressed participants. Controlling for the effects of sex, obstruction status, age, smoking status, visceral adipose tissue, and metabolic syndrome, participants with anxiety at baseline showed a significantly higher loss of FEV1 (β= -2.77; p=0.006) and FVC (β= -3.57; p=0.001). Spirometric changes were not associated with changes in lung volumes or airway conductance. <bold>Conclusion:</bold> Anxiety is an independent risk factor for accelerated lung function decline, underscoring the importance of screening for and treating anxiety in the elderlies.