The burden of chronic obstructive pulmonary disease in the elderly population

• Published in: Respiratory investigation Vol. 52; no. 5; pp. 296 - 301
• Main Authors: Kobayashi, Seiichi, MD, PhD, Yanai, Masaru, MD, PhD, Hanagama, Masakazu, MD, PhD, Yamanda, Shinsuke, MD, PhD
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.09.2014
• Subjects: Activities of Daily Living; Age Factors; Aged; Aged, 80 and over; Cardiovascular Diseases - epidemiology; Chronic obstructive pulmonary disease; Cognition Disorders - epidemiology; Comorbidity; Cost of Illness; Cross-Sectional Studies; Disease Progression; Drug adherence; Dyspnea; Elderly; Exercise Tolerance; Female; Geriatric condition; Humans; Internal Medicine; Japan; Male; Middle Aged; Neoplasms - epidemiology; Prospective Studies; Pulmonary Disease, Chronic Obstructive - epidemiology; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary/Respiratory; Japan; GOLD; forced expiratory volume in 1 s; forced vital capacity; ADL; FVC; FEV 1; activities of daily living; Geriatric condition; The Global Initiative for Chronic Obstructive Lung Disease; Elderly; Drug adherence; COPD; chronic obstructive pulmonary disease; FEV1; Chronic obstructive pulmonary disease
• ISSN: 2212-5345; 2212-5353
• DOI: 10.1016/j.resinv.2014.04.005

Abstract Background Chronic obstructive pulmonary disease (COPD) is a common disease and an important health care problem in older adults. The impact of age and specific geriatric issues on COPD in elderly patients has not been well established. Methods A cross-sectional study of elderly COPD patients was conducted in Japan by using a regional COPD registry database. We compared indices of disease severity (pulmonary function, exercise tolerance, quality of life, and frequency of exacerbations), presence of comorbidities, geriatric conditions (cognitive function, mental status, and activities of daily living [ADL]), and adherence to prescribed drug regimens between elderly and younger patients with COPD. Results In total, 279 patients with stable COPD (median age, 74 years) were identified; 86% of these patients were elderly (65 years of age or older). Elderly COPD patients, especially those who were 75 years of age or older, had significantly more cases of dyspnea, lower exercise tolerance, and poorer ADL and a higher incidence of severe exacerbations than younger patients (all P <0.05). In addition, the prevalence of comorbidities, including cardiovascular disease and cancer, was significantly higher in elderly COPD patients. Elderly COPD patients had specific geriatric conditions, including cognitive impairment. Adherence to inhaled drug regimens in elderly patients was as favorable as that in younger patients. Conclusions Age and specific geriatric conditions have a great negative impact on COPD in elderly patients. Geriatric conditions should be addressed in the management of elderly COPD patients.