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COPD Life Expectancy

COPD Life Expectancy
Though COPD is a life-threatening medical condition with no cure, it can be managed well with proper treatment and care, which can result in an increased life expectancy.
Sonia Nair
It is almost impossible to come up with accurate figures, as far as life expectancy and medical conditions are concerned. In most cases, the figures are rough estimates that are calculated on the basis of certain factors like the severity of the given medical condition. It may also happen that those in the severe stages of the disease outlive those in mild and moderate stages. Instead of worrying about the figures, it is always better to concentrate on proper treatment and lifestyle changes, especially in a disease like COPD. This will help you manage the symptoms and hinder the progression of the disease to a great extent. Here is a brief overview about the factors that influence the life expectancy of a person, who has been detected with COPD.
COPD Prognosis

Severity of a medical condition is one of the major factors that influence its prognosis. However, there are many other factors that can affect the life expectancy of a person with a certain medical condition. In case of COPD, smoking status and other health problems are also very vital. Different methods have been developed to measure the life expectancy of those affected with COPD. The most commonly used methods are the GOLD staging system and the BODE index.

COPD Staging and GOLD System

Calculation of COPD life expectancy is mainly based on the degree of severity of the disease, which is measured through a pulmonary function test called spirometry. This test measures the degree of airway obstruction and the capacity of the lungs to hold air and blow it out. As per this test, COPD is classified as mild, moderate, severe and very severe. Usually, the spirometry measurements are given in FEV1/FVC ratios. FEV1 is the forced expiratory volume in one second, which is the greatest volume of air that can be breathed out in the first second of a breath. FVC denotes the forced vital capacity, which is the greatest volume of air that can be breathed out in a whole large breath. The severity of COPD is determined as per the FEV1 value, measured twice - before and after administering a bronchodilator. The person should be healthy and free of any respiratory tract infection, during the test. He/she must also avoid taking any bronchodilator, for at least 24 hours before the test. This staging system was developed by the Global Initiative for Chronic Obstructive Lung Disease.
Stage 1: FEV1 value less than 80% - Mild COPD
The person may experience chronic cough and production of sputum.
Stage 2: FEV1 value between 50% to 80% - Moderate COPD.
Breathlessness may develop, especially during exertion. Cough and other symptoms may or may not worsen.
Stage 3: FEV1 value between 30% to 50% - Severe COPD
The symptoms worsen further and may affect the day-to-day activities.
Stage 4: FEV1 value below 30% - Very Severe COPD
The symptoms become very severe and life-threatening.

In general, it can be said that the life expectancy of those in the severe stages would be lesser than those in the mild and moderate stages. However, there are various other factors that may influence the life expectancy of a COPD patient. They include smoking, heart diseases, malnutrition and other medical conditions like kidney failure.According to a 2009 study*, smoking is one of those factors that can affect the life expectancy of a COPD patient to a large extent. The study was conducted on patients, aged 50 and above. They included smokers, former smokers and non-smokers (who have never smoked in their life). These results show how smoking affects the life expectancy of COPD patients (65-year-old male and female Caucasians, who were otherwise healthy).

Males Stage 1 Stage 2 Stage 3 & 4
Non Smokers 18 yrs 17.1 yrs 16.5 yrs
Former Smokers 17.4 yrs 15.9 yrs 11.7 yrs
Current Smokers 14 yrs 12.1 yrs 8.5 yrs

Females Stage 1 Stage 2 Stage 3 & 4
Non Smokers 20.5 yrs 19.3 yrs 18.4 yrs
Former Smokers 19.8 yrs 17.6 yrs 13.3 yrs
Current Smokers 17.2 yrs 15.2 yrs 11.3 yrs
* Reference: International Journal of Chronic Obstructive Pulmonary Disease

BODE Index

Nowadays, BODE index is commonly used for calculating COPD life expectancy. Apart from the lung function, other factors like the body mass index (BMI), exercise tolerance and degree of shortness of breath, are also taken into account. Let us take a look at how the COPD stages are interpreted as per the BODE index method.

B (body mass index)
O (airway obstruction)
D (severity of dyspnea)
E (exercise tolerance)
Different methods are used to measure these four factors. While a BMI chart will be sufficient to find out the body mass index of a person, obstruction of airways can be measured using spirometry, which provides the FEV1 value. Severity of dyspnea (shortness of breath) is measured as per the MMRC Dyspnea Scale, which provides five grades (0 to 4) on the basis of physical activities that can generate breathlessness. Exercise tolerance is often measured by the 6-minute walk test. The BODE index score can be calculated using the values of these four parameters. Higher BODE scores are often linked to higher risk of death.

BODE Index Score

Body Mass Index
BMI > 21 = 0 point
BMI ≤ 21 = 1 point

Airway Obstruction
FEV1 Value ≥ 65% = 0 point
FEV1 Value 50% to 64% = 1 point
FEV1 Value 36% to 49% = 2 points
FEV1 Value ≤ 35% = 3 points

MMRC Dyspnea Scale
Grade 0 to 1 = 0 point
Grade 2 = 1 point
Grade 3 = 2 points
Grade 4 = 3 points

Exercise Tolerance - Six-Minute Walk Test
≥ 350 meters = 0 point
250 to 349 meters = 1 point
150 to 249 meters = 2 points
≤ 149 meters = 3 points
Dyspnea Grade Indication: The grading system as per the MMRC Dyspnea Scale shows the severity of breathlessness. While grade 0 indicates breathlessness only during strenuous exercise, those in grade 1 develop shortness of breath while climbing a hill or while walking fast on the level. If you walk (on the level) slower than those of your age, you are in grade 2. Such people may take breaks while walking. Those in grade 3 have to stop walking, every few minutes, to catch their breath. Grade 4 indicates severe breathlessness that makes it difficult to perform even simple tasks, like undressing.

In short, BODE-index is a 10-point scale. The higher the score, the lower the life expectancy. It has been observed that respiratory problems are associated with higher risk of death, when compared to other parameters, especially for those with high BODE scores. This is only a brief overview about COPD life expectancy and BODE index. Interpretation of BODE index score should be done by a health care professional only.

To conclude, it is not easy to predict the life expectancy of a COPD patient, who falls under a particular stage, unless all other factors like age, gender, height, weight, mode of treatment, health condition, and lifestyle changes (like cessation of smoking) are taken into consideration. In general, we can say that the life expectancy decreases, as the degree of severity of the disease increases. Life expectancy of those with mild COPD could be higher than those with moderate and severe condition. However, there are many instances wherein those in the severe category lived much longer than expected. Effective treatment during the early stages could be one of the factors, which can increase life expectancy of COPD patients.

There is no hard and fast rule or exact figures as far as COPD life expectancy is concerned. It may vary with individual conditions and severity of the disease. All you can do is to start treatment during the early stages itself, so as to avoid complications and to inhibit further progression of the disease. Lifestyle changes like smoking cessation, sticking to a healthy diet, regular exercise and some relaxation techniques like yoga could be beneficial.

Learn More about COPD

COPD or chronic obstructive pulmonary disease is a chronic lung disease, which is characterized by narrowing of the airways and results in many life-threatening complications. COPD can be more accurately defined as a group of lung diseases, especially, emphysema and chronic bronchitis. Chronic asthmatic bronchitis may also lead to COPD. However, the characteristic feature of this disease is narrowing of airways, which eventually affects the functioning of the lungs. The lungs fail to exchange oxygen and carbon dioxide effectively. So, it is a progressive disease that worsens with time and cause debilitating symptoms. It is a condition that is not easily reversible and is one among the leading causes of death, across the globe. Treatment is mainly aimed at minimizing severity of the symptoms, reduce the risk of complications and to enable the patients to lead an active life.

While COPD encompasses respiratory conditions like emphysema and chronic bronchitis, smoking (includes long-term exposure to secondhand smoke) is cited as the single largest cause of this life-threatening disease. Air pollution and exposure to occupational fumes may also lead to this condition. Even exposure to cooking fire without proper ventilation may lead to COPD, in the long run. Chronic acid reflux or GERD is said to worsen COPD symptoms. In some rare cases, genetic disorders can also lead to this condition.

COPD symptoms may vary as per the prominent lung disease in the affected person. It is already mentioned that COPD is a condition, which may involve more than one lung disease. If the prominent disease is emphysema, the patient may experience chest tightness, wheezing and shortness of breath, especially during strenuous physical activities. If it is chronic bronchitis, the symptoms are chronic cough with yellowish sputum, frequent respiratory infections and shortness of breath in the later stages. Chronic asthmatic bronchitis is nothing but, chronic bronchitis combined with asthma, and this condition has an additional symptom, apart from those experienced in chronic bronchitis - wheezing. COPD is a condition, which can cause complications like high blood pressure, heart disease, frequent respiratory infections and depression. Usually, drugs like bronchodilators, steroids and anti-inflammatory medication, are used for treating this condition. Oxygen therapy is also found to be effective to some extent. Lung transplant may be done in those with severe symptoms.

Disclaimer: This article is for informational purposes only and should not be used as a replacement for expert medical advice. Visiting your physician is the safest way to diagnose and treat any health condition.
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