Factors Influencing Disease Perception Among Elderly Patients with Chronic Obstructive Pulmonary Disease in China: A Cross-Sectional Study

Houmin Li,1 Lijun Liu,1 Chuchu Xu,2 Jun Xie1 1Department of General Medicine, The Second People’s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, People’s Republic of China; 2Department of Respiration and Critical Care Medicine, The Second People’s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, People’s Republic of ChinaCorrespondence: Jun Xie, Department of General Medicine, The Second People’s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Intersection of Guangde Road and Leshui Road, Yaohai District, Hefei, 230011, People’s Republic of China, Tel +86 13731962160, Email [email protected]: Community-based management improve chronic disease outcomes, but their impact on disease perception and frailty in chronic obstructive pulmonary disease (COPD) patients remains underexplored.Objective: To identify factors influencing disease perception in elderly COPD patients and assess the role of community-based management.Methods: In this cross-sectional study, 223 COPD patients aged ≥ 60 years (diagnosed per the 2021 Guidelines for Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease) were randomly selected. Dyspnoea severity was graded via the mMRC scale; COPD severity incorporated spirometry (FEV1/FVC) and symptom burden (COPD Assessment Test). Participants completed the Brief Illness Perception Questionnaire (BIPQ), Tilburg Frailty Indicator (TFI), and a general information survey. Differences between community-managed (n=81) and non-community-managed (n=142) groups were compared. Pearson’s correlation and multivariate linear regression analyses identified predictors of disease perception.Results: Mean BIPQ score was 46.87± 7.47 (moderate threat perception), and frailty score was 8.02± 2.38. Disease perception positively correlated with total frailty and its subdomains (P< 0.05). Community-managed patients had significantly lower BIPQ and TFI scores (P< 0.05). Regression revealed disease duration (β=0.28), dyspnoea severity (β=0.22), and frailty (β=0.19) as positive predictors of disease perception; community management (β=− 0.15) and older age (β=− 0.12) were negative predictors (P< 0.05). The model explained 46.0% of variance (R2=0.46, F=18.03, P< 0.001).Conclusion: Elderly patients with COPD demonstrated strong links between disease perception and frailty. Community-based management considerably reduced these scores, indicating its potential to improve patient outcomes.Keywords: chronic obstructive pulmonary disease, the elderly, disease perception, frailty