Amit D Parulekar1, Carlos Martinez2, Chu-Lin Tsai3, Nicholas Locantore4, Mustafa Atik1, Abebaw M Yohannes5, Christina C Kao1, Hassan Al-Azzawi1, Ali Mohsin1, Robert A Wise6, Marilyn G Foreman7, Dawn L Demeo8, Elizabeth A Regan9, Barry J Make9, Aladin M Boriek1, Laura E Wiener10, Nicola A Hanania1. 1. Section of Pulmonary, Critical Care, and Sleep, Baylor College of Medicine, Houston, TX. 2. University of Michigan, Ann Arbor, MI. 3. Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan. 4. GSK Research and Development, King of Prussia, PA. 5. Department of Physical Therapy, Azusa Pacific University, Azusa, CA. Electronic address: ayohannes@apu.edu. 6. Johns Hopkins University, Baltimore, MD. 7. Pulmonary and Critical Care Medicine Division, Morehouse School of Medicine, Atlanta, GA. 8. Channing Division of Network Medicine and Pulmonary and Critical Care Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. 9. Department of Medicine, National Jewish Health, Denver, CO. 10. Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Abstract
RATIONALE: The prevalence of chronic obstructive pulmonary disease (COPD) and its associated comorbidities increase with age. However, little is understood about differences in the disease in patients over 65 years of age compared with younger patients. OBJECTIVES: To determine disease characteristics of COPD and its impact in older patients compared with younger patients. METHODS: We examined baseline characteristics of patients with COPD (global obstructive lung disease stage II-IV) in 2 large cohorts: Genetic Epidemiology of COPD Study (COPDGene) and Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE). We compared demographics, indices of disease severity, prevalence of comorbidities, exacerbation frequency, and quality of life scores in patients ≥65 years of age vs patients <65 years of age. We also tested for associations of age with disease characteristics and health outcomes. RESULTS: In the COPDGene cohort, older patients (n = 1663) had more severe disease as measured by forced expiratory volume in 1 second (1.22 vs 1.52 L, P < .001), use of long-term oxygen therapy (35% vs 22%, P < .001), 6-minute walk distance (355 vs 375 m, P < .001), and radiographic evidence of emphysema (14% vs 8%, P < .001) and air trapping (47% vs 36%, P < .001) and were more likely to have comorbidities compared with younger patients (n = 2027). Similarly, in the ECLIPSE cohort, older patients (n = 1030) had lower forced expiratory volume in 1 second (1.22 vs 1.34 L, P < .001), greater use of long-term oxygen therapy (7% vs 5%, P = .02), shorter 6- minute walk distance (360 vs 389 m, P < .001), and more radiographic evidence of emphysema (17% vs 14%, P = .009) than younger patients (n = 1131). In adjusted analyses of both cohorts, older age was associated with decreased frequency of exacerbations [odds ratio = 0.52, 95% confidence interval (CI) = 0.43-0.64 in COPDGene, odds ratio = 0.79, 95% CI = 0.64-0.99 in ECLIPSE] and a better quality of life (lower St. Georges respiratory questionnaire score) (β = -8.7, 95% CI = -10.0 to -7.4 in COPDGene, β = -4.4, 95% CI = -6.1 to -3.2 in ECLIPSE). CONCLUSIONS: Despite greater severity of illness, older patients with COPD had better quality of life and reported fewer exacerbations than younger patients. Although this observation needs to be explored further, it may be related to the fact that older patients change their expectations and learn to adapt to their disease.
RATIONALE: The prevalence of chronic obstructive pulmonary disease (COPD) and its associated comorbidities increase with age. However, little is understood about differences in the disease in patients over 65 years of age compared with younger patients. OBJECTIVES: To determine disease characteristics of COPD and its impact in older patients compared with younger patients. METHODS: We examined baseline characteristics of patients with COPD (global obstructive lung disease stage II-IV) in 2 large cohorts: Genetic Epidemiology of COPD Study (COPDGene) and Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE). We compared demographics, indices of disease severity, prevalence of comorbidities, exacerbation frequency, and quality of life scores in patients ≥65 years of age vs patients <65 years of age. We also tested for associations of age with disease characteristics and health outcomes. RESULTS: In the COPDGene cohort, older patients (n = 1663) had more severe disease as measured by forced expiratory volume in 1 second (1.22 vs 1.52 L, P < .001), use of long-term oxygen therapy (35% vs 22%, P < .001), 6-minute walk distance (355 vs 375 m, P < .001), and radiographic evidence of emphysema (14% vs 8%, P < .001) and air trapping (47% vs 36%, P < .001) and were more likely to have comorbidities compared with younger patients (n = 2027). Similarly, in the ECLIPSE cohort, older patients (n = 1030) had lower forced expiratory volume in 1 second (1.22 vs 1.34 L, P < .001), greater use of long-term oxygen therapy (7% vs 5%, P = .02), shorter 6- minute walk distance (360 vs 389 m, P < .001), and more radiographic evidence of emphysema (17% vs 14%, P = .009) than younger patients (n = 1131). In adjusted analyses of both cohorts, older age was associated with decreased frequency of exacerbations [odds ratio = 0.52, 95% confidence interval (CI) = 0.43-0.64 in COPDGene, odds ratio = 0.79, 95% CI = 0.64-0.99 in ECLIPSE] and a better quality of life (lower St. Georges respiratory questionnaire score) (β = -8.7, 95% CI = -10.0 to -7.4 in COPDGene, β = -4.4, 95% CI = -6.1 to -3.2 in ECLIPSE). CONCLUSIONS: Despite greater severity of illness, older patients with COPD had better quality of life and reported fewer exacerbations than younger patients. Although this observation needs to be explored further, it may be related to the fact that older patients change their expectations and learn to adapt to their disease.
Authors: J J Soler-Cataluña; M A Martínez-García; P Román Sánchez; E Salcedo; M Navarro; R Ochando Journal: Thorax Date: 2005-07-29 Impact factor: 9.139
Authors: Yannick M T A van Durme; Katia M C Verhamme; Theo Stijnen; Frank J A van Rooij; Geert R Van Pottelberge; Albert Hofman; Guy F Joos; Bruno H Ch Stricker; Guy G Brusselle Journal: Chest Date: 2009-02 Impact factor: 9.410
Authors: Carlos H Martinez; Alejandro A Diaz; Amit D Parulekar; Stephen I Rennard; Richard E Kanner; Nadia N Hansel; David Couper; Kristen E Holm; Karin F Hoth; Jeffrey L Curtis; Fernando J Martinez; Nicola A Hanania; Elizabeth A Regan; Robert Paine; Christine T Cigolle; MeiLan K Han Journal: Chest Date: 2015-12-17 Impact factor: 9.410
Authors: Diego J Maselli; Surya P Bhatt; Antonio Anzueto; Russell P Bowler; Dawn L DeMeo; Alejandro A Diaz; Mark T Dransfield; Ashraf Fawzy; Marilyn G Foreman; Nicola A Hanania; Craig P Hersh; Victor Kim; Gregory L Kinney; Nirupama Putcha; Emily S Wan; J Michael Wells; Gloria E Westney; Kendra A Young; Edwin K Silverman; MeiLan K Han; Barry J Make Journal: Chest Date: 2019-05-30 Impact factor: 9.410
Authors: Juan José Soler-Cataluña; Pere Almagro; Arturo Huerta; Diego González-Segura; Borja G Cosío Journal: Int J Chron Obstruct Pulmon Dis Date: 2021-01-25