Health outcomes in older adults with COPD: the role of clinical and psychosocial factors in post-acute geriatric rehabilitation

Older adults with COPD hospitalised for an acute exacerbation often face frailty, comorbidity, and psychosocial challenges. This study aimed to identify clinical and psychosocial predictors of changes in disease-specific health status over three months in older adults with COPD following hospitalisation for an exacerbation and indicated for geriatric COPD rehabilitation (the GR_COPD programme). Prospective cohort study with three-month follow-up. Two Dutch hospitals; 78 patients participated in the GR_COPD programme and 80 patients received usual care. Disease-specific health status was assessed with the Clinical COPD Questionnaire (CCQ) at baseline and 3 months. Regression analyses were used to identify predictors of CCQ change, with a sensitivity analysis using the minimal clinically important difference (MCID). Baseline CCQ was the most consistent predictor of change, with patients reporting worse initial health status showing greater improvement. Participation in the GR_COPD programme and comorbidity burden were independently associated with achieving clinically meaningful improvement, whereas exacerbation history and psychosocial factors were not. Baseline health status was the most consistent predictor of short-term change in disease-specific health status following hospitalisation for COPD exacerbation. Participation in the GR_COPD programme was associated with clinically meaningful improvement in frail older adults. Taken together, these findings underscore the value of systematic baseline clinical assessment to better understand short-term trajectories in frail older adults with COPD.