Millions of adults in the United States have chronic obstructive pulmonary disease (COPD), and just as many are developing this condition. But many of them are unaware of it, according to the National Heart Lung and Blood Institute (NHLBI).
One question many people with COPD have is, “How long can I live with COPD?” There’s no way to predict the life expectancy of those who have COPD. But having this progressive lung disease does shorten lifespan. How much so depends upon some factors, like your overall health and whether you have other diseases such as heart disease or diabetes.
Researchers recently came up with a way to assess the health of someone with COPD. The method combines lung function test results with a person’s symptoms. These measures result in labels that can help predict life expectancy in those with COPD.
The Global Initiative for Chronic Obstructive Lung Disease (GOLD), devised the new system. GOLD is an international group of lung health experts who periodically produce guidelines for doctors to use in the care of people with COPD and other lung diseases. Doctors use the GOLD system to assess people with COPD in “stages” of the disease. Staging is a way to measure the severity of COPD. It uses the forced expiratory volume (FEV1), a test that determines the amount of air a person can forcefully exhale 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 or more
- GOLD 2: FEV1 of 50 to 79 percent
- GOLD 3: FEV1 of 30 to 49 percent
- GOLD 4: FEV1 of less than 30 percent
The second part of the assessment relies on symptoms such as dyspnea (difficulty breathing) and 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.
A person with no exacerbations or one that did not require hospital admission in the past year would be in Group A or B. This will also depend on an assessment of their breathing.
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.
Under the new guidelines, someone labeled GOLD Grade 4, Group D, would have the most serious classification of COPD. And they will probably have a worse outlook and 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 into account an overall picture of how COPD affects your life. Though the BODE index is used by physicians, its value in predicting the course of the disease and life expectancy may be lessening as researchers learn more about the disease.
The body mass index (BMI), or weight adjusted for height, can determine if a person is overweight or has obesity. BMI can also determine whether you are too thin. People who are too thin have a worse outlook.
This refers to the FEV1, as in the GOLD system.
Some studies suggest those who have more trouble breathing have a worse chance of survival than those who have better breathing ability.
This means how well you are able to tolerate exercise. It’s often measured by a test called the “6-minute walk test.”
Routine blood 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 (EBR) correlate to the severity of COPD. A routine blood test can measure these markers. The NLR may be particularly helpful as a predictor for life expectancy.
The average five-year mortality rate of someone with COPD ranges between 40 and 70 percent. 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 who has COPD and smokes has the following reductions in life expectancy:
- stage 1: 0.3 years
- stage 2: 2.2 years
- stage 3 or 4: 5.8 years
For former smokers, the reduction in life expectancy is:
- stage 2: 1.4 years
- stage 3 or 4: 5.6 years
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 never smokers, the difference in life expectancy for people at stage 0 and people at stage 1 was statistically insignificant.
What is 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 keep your weight up 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.
Also valuable is participation in a pulmonary rehabilitation program. You will 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. And learn the warning signs of breathing problems and what you should do if you feel an exacerbation or minor flare-up occur.
The more you can do to improve your overall health, the longer and fuller your life can be.