CAD Widely Affects Daily Life, Raises Risk of Mental Illness, Research Shows

Marisa Wexler MS avatar

by Marisa Wexler MS |

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Cold agglutinin disease (CAD) disease negatively affects a variety of aspects of daily living, with patients often experiencing fatigue, according to new research.

In a separate study, it was found that CAD patients appear to be at an increased risk of anxiety or depression.

Researchers from Sanofi and other institutions will be presenting these findings at the American Society of Hematology Annual Meeting, taking place virtually this month.

CAD can cause a variety of symptoms and affect life in many ways. By conducting research to examine exactly what symptoms are most common and problematic for people with CAD, scientists can identify areas where current care falls short or where more research is needed.

In one presentation, titled, “Patient-Reported Disease Burden: In-Depth Interviews of Patients with CAD,” researchers conducted interviews with 16 people with CAD living in the U.S. to better understand their symptoms and the effect of the disease on their daily life.

All interviewees were white and non-Hispanic, 62.5% were female, and the average age was 67.8. Nine of the interviewees reported taking folic acid; the remaining said they were not currently on any treatment.

The most frequently reported symptoms were fatigue or lack of energy (93.8%), reaction to cold environments (93.8%), breathlessness (68.8%), and difficulty concentrating (68.8%). When questioned, 43.8% of the interviewees said they had experienced sleep disturbances.

Given the commonality of fatigue as a symptom of CAD, the researchers asked participants their opinions on the Functional Assessment of Chronic Illness Therapy-Fatigue scale (FACIT-F), a standardized measurement of fatigue.

Interviewees said that the FACIT-F was easy to understand, measured aspects of fatigue important to them, and was not missing any important concepts, providing “support for the content validity of the FACIT-F in patients with CAD,” the researchers wrote.

Most (68.8%) of the interviewees said they had made lifestyle and behavioral changes to help manage CAD symptoms — for example, bringing extra layers in case of cold and limiting time spent outdoors.

“Patients with CAD experienced negative effects on daily activities, physical health/activities, social/ leisure activities/relationships, the ability to concentrate/recall, and mood/emotions mostly owing to fatigue/lack of energy and reactions to cold environments,” the researchers concluded.

In a separate presentation, “Medically Attended Anxiety or Depression Is Increased Among Newly Diagnosed Patients with Cold Agglutinin Disease (CAD),” researchers analyzed data from an insurance database to examine the association between CAD and mental illness.

They identified a total of 384 people with CAD (mean age of 70 years). Each patient was matched to 10 people without CAD in the database, who were similar in terms of sex, age, race, region of residence, and active time.

People with CAD were about 60% more likely to have anxiety or depression needing medical care than those without the disorder, according to the results.

CAD patients were also about twice as likely to be prescribed medication or psychotherapy for anxiety and depression after their diagnosis or to be hospitalized for a depression or anxiety-related event, along with medication or psychotherapy.

“To our knowledge, this is the first study to evaluate anxiety or depression among patients with CAD,” the researchers concluded. “Our study indicates that medically attended depression and anxiety manifest at a higher rate in patients with CAD compared with a matched non-CAD cohort.”

Findings suggest that CAD patients experience additional non-blood related symptoms that affect their health and quality of life. The researchers called for further study into how CAD affects mental health and quality of life.