MedWire News: The presence of mild chronic obstructive pulmonary disease (COPD) is not associated with reduced life expectancy among individuals aged over 65 years, researchers have found.
Moderate and severe COPD is known to have a significant negative effect on personal independence and survival rates, explain Claudio Pedone (Universita Campus Biomedico, Rome, Italy) and colleagues.
But they add that less is known about the effects of mild COPD on independence and survival, particularly in elderly people.
To investigate further, the researchers analyzed data on 1159 individuals (49% women), aged an average of 73.2 years, who participated in the Respiratory Health in the Elderly study.
The team used three definitions of mild COPD based on current guidelines from the American Thoracic Society/European Respiratory Society (ATS/ERS), the British Thoracic Society/UK National Institute for Health and Clinical Excellence (BTS/NICE), and the Global Initiative for Obstructive Lung Disease (GOLD).
The ATS/ERS defines mild bronchial obstruction as an FEV1/forced vital capacity (FVC) below the lower limit of normal for age and a FEV1 of more than 70% of the predicted value. The BTS/NICE guidelines classify mild bronchial obstruction as a FEV1/FVC ratio of less that 0.7 and a FEV1 of 50–80% of the predicted value, and the GOLD guidelines classify it as an FEV1/FVC of less than 0.7 and an FEV1 of more than 80% of the predicted value.
Among participants aged 65 to 75 years, mild obstruction was present in 18.8%, 18.5%, and 10.8% using the ATS/ERS, BTS/NICE, and GOLD classification, respectively. The prevalence of mild obstruction among participants over the age of 75 years was similar to that of the 65-75 year age group using the ATS/ERS and BTS/NICE classifications, while using the GOLD definition the figure was nearly doubled (22.4%).
Using any of these definitions, the researchers found that there were no significant differences in physical capabilities and survival rates between participants with mild COPD and those without bronchial obstruction, after accounting for age, comorbidity, and other confounding factors.
Pedone and team conclude in the journal BMC Pulmonary Medicine: “Our data indicate that mild COPD may not affect survival and personal capabilities of patients over 65 years, regardless of the criteria used to diagnose it.
“In this group of patients, comorbidity and age itself likely are the major determinants of these outcomes.”
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