Millions of adults in the United States have chronic obstructive pulmonary disease (COPD), and just as many are developing it. But many of them are unaware, according to the
One question many people with COPD have is, “How long can I live with COPD?” There’s no way to predict the exact life expectancy, but having this progressive lung disease can shorten lifespan.
Researchers over the years have come up with a way to assess the health of someone with COPD. One of the most current methods combines spirometry lung function test results with a person’s symptoms. These result in labels that can help predict life expectancy and guide treatment choices in those with COPD.
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) is one of the most used systems of classifying COPD. GOLD is an international group of lung health experts who periodically produce and update guidelines for doctors to use in the care of people with COPD.
Doctors use the GOLD system to assess people with COPD in “grades” of the disease. Grading is a way to measure the severity of the condition. It uses the forced expiratory volume (FEV1), a test that determines the amount of air a person can forcefully exhale from their lungs in one second, to categorize the severity of COPD.
The most recent guidelines make FEV1 part of the assessment. Based on your FEV1 score, you receive a GOLD grade or stage as follows:
- GOLD 1: FEV1 of 80 percent predicted or more
- GOLD 2: FEV1 of 50 to 79 percent predicted
- GOLD 3: FEV1 of 30 to 49 percent predicted
- GOLD 4: FEV1 of less than 30 percent predicted
The second part of the assessment relies on symptoms such as dyspnea, or difficulty breathing, and degree and amount of acute exacerbations, which are flare-ups that may require hospitalization.
Based on these criteria, people with COPD will be in one of four groups: A, B, C, or D.
Someone with no exacerbations or one that didn’t require hospital admission in the past year would be in group A or B. This will also depend on an assessment of breathing symptoms. Those with more symptoms would be in group B, and those with less symptoms would be in group A.
People with at least one exacerbation that required hospitalization, or at least two exacerbations that did or didn’t require hospital admission in the past year, would be in Group C or D. Then, those with more breathing symptoms would be in group D, and those with less symptoms would be in group C.
Under the new guidelines, someone labeled GOLD Grade 4, Group D, would have the most serious classification of COPD. And they’ll technically have a shorter life expectancy than someone with a label of GOLD Grade 1, Group A.
Another measure that uses more than just the FEV1 to gauge a person’s COPD condition and outlook is the BODE index. BODE stands for:
- body mass
- airflow obstruction
- exercise capacity
BODE takes an overall picture of how COPD affects your life. Though the BODE index is used by some physicians, its value may be lessening as researchers learn more about the disease.
The body mass index (BMI), which looks at body mass based on height and weight parameters, can determine if a person is overweight or obese. BMI can also determine if someone’s too thin. People who have COPD and are too thin may have a poor outlook.
This refers to the FEV1, as in the GOLD system.
Some prior studies suggest that trouble breathing can affect outlook for COPD.
This means how well you’re able to tolerate exercise. It’s often measured by a test called the “6-minute walk test.”
One of the key features of COPD is systemic inflammation. A blood test that checks for certain markers of inflammation may be helpful.
Research published in the International Journal of Chronic Obstructive Pulmonary Disease suggests that the neutrophil-to-lymphocyte ratio (NLR) and eosinophil-to-basophil ratio significantly correlate to the severity of COPD.
The above article suggests a routine blood test can measure these markers in those with COPD. It also noted that the NLR may be particularly helpful as a predictor for life expectancy.
As with any serious disease, such as COPD or cancer, probable life expectancy is based largely on the severity or stage of the disease.
For example, in a 2009 study published in the International Journal of Chronic Obstructive Pulmonary Disease, a 65-year-old man with COPD who currently smokes tobacco has the following reductions in life expectancy, depending on stage of COPD:
- stage 1: 0.3 years
- stage 2: 2.2 years
- stage 3 or 4: 5.8 years
The article also noted that for this group, an additional 3.5 years were also lost to smoking compared with those who never smoked and didn’t have lung disease.
For former smokers, the reduction in life expectancy from COPD is:
- stage 2: 1.4 years
- stage 3 or 4: 5.6 years
The article also noted that for this group, an additional 0.5 years were also lost to smoking compared to those who never smoked and didn’t have lung disease.
For those who never smoked, the reduction in life expectancy is:
- stage 2: 0.7 years
- stage 3 or 4: 1.3 years
For former smokers and those who’ve never smoked, the difference in life expectancy for people at stage 0 and people at stage 1 wasn’t as significant, as opposed to those who were current smokers.
What’s the upshot of these methods of predicting life expectancy? The more you can do to keep from progressing to a higher stage of COPD the better.
The best way to slow down the progression of the disease is to stop smoking if you smoke. Also, avoid secondhand smoke or other irritants such as air pollution, dust, or chemicals.
If you’re underweight, it’s helpful to maintain a healthy weight with good nutrition and techniques to increase food intake, such as eating small, frequent meals. Learning how to improve breathing with exercises such as pursed lip breathing will also help.
You may also want to participate in a pulmonary rehabilitation program. You’ll learn about exercises, breathing techniques, and other strategies to maximize your health.
And while exercise and physical activity may be challenging with a breathing disorder, it’s one of the best things you can do for the health of your lungs and the rest of your body.
Talk with your doctor about a safe way to start exercising. Learn the warning signs of breathing problems and what you should do if you notice a minor flare-up. You’ll want to follow any COPD medication therapy prescribed to you by your doctor.
The more you can do to improve your overall health, the longer and fuller your life can be.
Did you know?
COPD is the third leading cause of death in the United States, according to the American Lung Association.