The ROC analysis showed that worsening (change in grading from to any other grade: A-B, A-C, A-D, B-C, B-D, C-D) of the new GOLD stratification at one year was independently associated with longitudinal changes in the following parameters: mMRC (C-statistic 0.690, 95% CI 0.604-0.777, P < 0.001), CAT (C-statistic 0.716, 95% CI 0.631-0.802, P < 0.001), FEV1% (C-statistic 0.669, 95% CI 0.580-0.758, P < 0.001), BODE index (C-statistic 0.745, 95% CI 0.672-0.818, P < 0.001), and depression (C-statistic 0.608, 95% CI 0.518-0.698, P = 0.026). Here, CAT is linked to major depressive disorder.