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COPD Stages and Life Expectancy

COPD Life Expectancy

Chronic obstructive pulmonary disease, or COPD, is a concerning diagnosis because there's no cure for the condition. According to the American Lung Association, more than 15 million U.S. residents have been diagnosed with COPD, and it’s the third leading cause of death from a disease in the country.

Those numbers could potentially be much higher, the association adds, because many millions of individuals have COPD but have never been diagnosed with the illness.

However, it's not all bad news when it comes to COPD. For people with COPD, life expectancy varies widely, depending on the severity of your condition and how closely you follow your treatment.

COPD stages

Doctors use a system of stages, established by the Global Initiative for Chronic Obstructive Lung Disease (GOLD), to identify how advanced person's COPD is. There are four stages, ranging from mild (GOLD 1) to very severe (GOLD 4). If you have COPD, its stage can affect your overall outlook, as well as your quality of life and life expectancy.

The main method used to determine your COPD stage is spirometry -- a medical test that measures how much air your lungs can hold and how fast you can expel it. A forced expiratory volume (FEV) of at least 80 percent means you are in the mild stage. FEV between 50 and 80 percent is moderate, and 30 to 50 percent is severe. If you have a forced expiratory volume less than 30 percent, this indicates that you have very severe COPD.

Spirometry isn't the only factor considered, however. Doctors also use questionnaires to determine the nature and severity of breathlessness, with options from getting breathless only during strenuous exercise to being too breathless to leave the house. Your doctor will ask about your sleep quality and whether you have symptoms such as coughing, mucus or chest tightness. Your doctor will also ask how often your COPD has gotten worse or flared up and the number of times you have been admitted to a hospital to treat it.

COPD treatment

Your doctor uses all of this information to plan the best course of treatment for you. The most important step in COPD treatment is to quit smoking if you’re a current smoker. The reality is that if you have COPD and continue to smoke, it’s only going to get worse, so quitting smoking is a must in order to improve your condition.

However, anyone who has been a smoker knows that quitting smoking can be easier said than done. Your best bet is to start by having a conversation about smoking with your doctor. Your doctor may recommend or prescribe a nicotine replacement product, which can help take the edge off as you transition away from smoking. Doctors can also provide information about support groups, as well as how to handle any relapses that may occur.

Most people with COPD will need to avoid smoke exposure as much as possible. If another loved one smokes in the home, you’ll want to encourage him or her to stop in order to avoid secondhand smoke exposure.

COPD medication is the other critical treatment for most people. Medication can help improve breathing by reducing swelling, relaxing the muscles around the lungs and reducing mucus production, according to the COPD Foundation.

The two main types of medications that help those with COPD breathe better are controller and rescue medications. Controller medications are taken on a regular basis to maintain breathing or prevent breathing problems. Rescue medications are used for flare-ups when shortness of breath is a problem.

Your doctor may recommend a nebulizer or an inhaler, depending on the medication type or your specific needs. A nebulizer is a machine that disperses the medicine into a fine mist that you inhale through a tube or mask, and an inhaler is a handheld dispenser that lets you breathe the medication directly into your lungs.

Other ways to manage COPD

Taking medication and quitting smoking are not the only management options available. Making certain lifestyle changes can also help. This may include:

  • Avoiding secondhand smoke and other indoor air pollutants
  • Eating healthy foods
  • Drinking plenty of water
  • Exercising regularly
  • Using a humidifier

Another approach that helps many people with COPD is known as controlled coughing. According to the Cleveland Clinic, this is a learned method of coughing that helps loosen and clear mucus without causing the airways to narrow or collapse. The technique involves short, sharp coughs from a sitting position, with your arms crossed. Talk to your doctor or other specialists about this technique if coughing is causing you pain or other problems.

You may also benefit from working with a pulmonary rehabilitation team, which may include doctors, physical therapists, nurses and dietitians. Through education, exercises and even nutritional advice, the team can help you manage the shortness of breath that is often part of having COPD.

If you have advanced COPD, you may need supplemental oxygen to manage your condition. Surgery can also help some people with severe forms of COPD. Options include:

  • Lung volume reduction surgery to remove damaged tissue from the upper lungs
  • Bullectomy to remove abnormal air spaces (bullae) from the lungs
  • Lung transplant

How COPD affects life expectancy

One of the more comprehensive collections of data on COPD life expectancy came from a large-scale study published in the journal PLOS One in 2019. The researchers analyzed almost 6 million death certificates in Poland, concluding that among men who died from COPD, the disease cost them 14.9 years of life. Women with COPD died 14.2 years earlier than expected, the study found.

Earlier research, published in the International Journal of Chronic Obstructive Pulmonary Disease in 2009, showed that the life expectancy of people with COPD can vary widely, depending on the stage, or severity, of their disease as well as their status as a smoker.

For example, the study found that, at 65 years of age, current smokers faced a 2.2 year reduction in life expectancy with stage 2 COPD, and a 5.8 year reduction in life expectancy with stage 3 or 4. That's in addition to 3.5 years lost because of smoking.

By comparison, former smokers with stage 2 COPD at age 65 lost 1.4 years of life expectancy and 5.6 years for stages 3 or 4. Those who had never smoked lost 0.7 years at stage 2 and 1.3 years at stages 3 or 4.

Predicting life expectancy with COPD

One tool that doctors can use to predict the life expectancy of someone with COPD is known as the BODE Index. According to the American Journal of Epidemiology, this index takes into account four factors in determining the severity of a person's COPD and, thus, how long the person is expected to live.

Factors considered in the BODE Index are a person’s body mass index (BMI), lung obstruction, severity of shortness of breath and his or her capacity for exercise. The higher or more severe any of these issues are for the person with COPD, the higher their score will be and the lower their life expectancy will be. People with a higher BODE Index are also more likely to be hospitalized because of their COPD.

While the BODE Index can be useful in evaluating a person and the severity of his or her COPD, it is seen more as a secondary tool for doctors to use along with other diagnostic aids. It was not designed to be used to direct or determine the effectiveness of COPD therapy.

The bottom line

Whatever your COPD stage, stop smoking and work closely with your doctor to find the best COPD treatment to manage your condition and increase your life expectancy.

Article references

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  2. Life expectancy and years of lost life in COPD…, International Journal of COPD, 2009, https://www.ncbi.nlm.nih.gov/pubmed/19436692
  3. COPD, Mayo Clinic, 2019, https://www.mayoclinic.org/diseases-conditions/copd/diagnosis-treatment/drc-20353685
  4. Global Initiative for Chronic Obstructive Lung Disease, 2018, https://goldcopd.org/wp-content/uploads/2018/02/WMS-GOLD-2018-Feb-Final-to-print-v2.pdf
  5. COPD Treatments, COPD Foundation, 2019, https://www.copdfoundation.org/Learn-More/I-am-a-Person-with-COPD/Treatments-Medications.aspx
  6. Standard expected years of life lost due to COPD in Poland from 1999 to 2014, PLOS, 2019, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0213581
  7. Coughing: Controlled Coughing, Cleveland Clinic, 2019, https://my.clevelandclinic.org/health/articles/8697-coughing-controlled-coughing
  8. Roberts MH, Mapel DW, Bruse S, Petersen H, Nyunoya T. Development of a Modified BODE Index as a Mortality Risk Measure Among Older Adults With and Without Chronic Obstructive Pulmonary Disease. Am J Epidemiol. 2013 Oct 1; 178(7): 1150–1160. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3857925/