Social isolation and loneliness and their associations with physical activity in COPD

Social isolation and loneliness are associated with morbidity, mortality and increased risk of hospitalisation in respiratory disease. Previous studies suggest associations between social isolation and loneliness with physical activity (PA) and performance in various diseases, however these relationships in people with COPD are unclear.

Using cross sectional data from 520 Mobilise-D study participants with stable COPD (age 68±8 yrs, FEV1 54±21 %pred), we explored the relationships between both amount of PA (steps/day) and PA experience (Clinical visit PROactive Physical Activity in COPD (C-PPAC) tool- amount/difficulty/total score) and loneliness (UCLA loneliness scale) and social isolation (domestic, remote social contact, social participation), respectively, using linear regression, adjusted for covariates.

Loneliness and social participation were both significantly associated with C-PPAC total score (coef: -0.05 p=0.002, coef:0.07 p=0.033) and C-PPAC difficulty score (coef:-0.13 p<0.001, coef:-0.18 p=0.001). Domestic isolation was associated with lower step count (coef:-0.06 p=0.014) and C-PACC-difficulty (coef:-0.08 p=0.048). No associations were found between remote social contact and PA (Table 1).

Social isolation and loneliness are related to subjective and objective components of PA in COPD. Increasing understanding of these relationships may identify treatment targets and contribute to intervention development.