Chronic obstructive pulmonary disease, or COPD, is a term for several chronic health conditions that reduce lung function. The outlook for a person with COPD depends on the stage of the disease and their overall health.
COPD causes airflow obstruction, impacting a person's ability to get enough oxygen into their lungs and move it through their body.
The disease progresses in stages with stage 1 being mild and stage 4 representing very severe COPD. Because the body requires oxygen to survive, COPD can be fatal.
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Exacerbations can also make the outlook worse. These episodes are when symptoms flare up and damage the lungs. If a person does not receive treatment, the disease may progress further.
It is not possible to reverse lung damage when a person has COPD, and the condition tends to become worse over time. Currently, there is no cure for COPD.
In this article, we explain how doctors work out the life expectancy for people with COPD and ways to improve a person's outlook.
There is no single life expectancy for people with COPD. Many factors are involved when working out an individual's life expectancy.
One of the strongest predictors of life expectancy with COPD is the forced expiratory volume (FEV1) percentage.
There are several systems in place that use FEV1 and other factors to assess life expectancy.
The FEV1 test measures how much air a person can expel from their lungs in 1 second. Its results show as a percentage of the airflow that doctors would predict for that person, according to their weight, height, and race.
A system called the Global Initiative for Chronic Obstructive Lung Disease (GOLD) helps many doctors assess the severity of a person's COPD. Its most recent guidelines involve the FEV1 test results as an indicator of severity.
A doctor will use these results to decide the disease grade. GOLD has four grades, each more severe than the previous one:
- GOLD 1: FEV1 less than or equal to 80% predicted
- GOLD 2: FEV1 50–80% predicted
- GOLD 3: FEV1 30–50% predicted
- GOLD 4: FEV1 less than 30% predicted
GOLD also takes into account symptoms such as breathing difficulties and the number of exacerbations, or flare-ups, that occur.
People with a higher GOLD grade have a lower life expectancy than those whose grade is a lower number.
Another measurement tool for COPD is the BODE scale.
BODE stands for body mass index (BMI), obstruction, breathlessness, and exercise capacity.
BODE scores also take FEV1 results into account, as well as the following factors:
- 6-minute walk test distance: This measures the distance a person can safely walk in 6 minutes.
- BMI: This represents how a person's body weight compares to their height, gender, and bone structure.
- Level of breathing difficulty: Those who become more easily winded will have higher scores on the BODE scale.
BODE scores range from 0–10. People with a score of 10 have the most impaired function and the worst outlook.
People can click here to find an automated calculator to determine their BODE score.
Predictive tests such as GOLD, BODE, and other scales are only a doctor's best estimate of life expectancy. Many people live longer, while others may have shorter expectancies.
Doctors use symptoms, several measurements of lung function, and a person's overall health to determine the severity of COPD.
Another system that doctors commonly use is the ADO scale, which stands for age, dyspnea, and obstruction.
Some experts also use the dyspnea, obstruction, smoking, and exercise capacity (DOSE) scale.
Doctors will consider the symptoms each individual is experiencing, along with their other medical conditions, to prescribe the best medication regime.
While there is no cure for COPD, medicines can help to reduce severe symptoms and may help a person with COPD to enjoy a better quality of life.
Medications commonly used to manage COPD include:
- Bronchodilator therapy: This involves medications that immediately open up the airways, such as inhaled albuterol.
- Maintenance medications: Long acting bronchodilators and other medications that people can take daily can help to keep airways open and reduce mucus production.
- Corticosteroids: These drugs include oral and inhaled steroids to reduce inflammation in the lungs.
- Oxygen therapy: Those who have difficulty maintaining a healthy oxygen level may benefit from wearing an oxygen mask at home or permanently.
Pulmonary rehabilitation involves sessions with a respiratory therapist or lung specialist who teaches techniques for better breathing.
Rehabilitation options may also include nutrition counseling and education about COPD. These options are most suitable for people with stable COPD and whose symptoms are not getting noticeably worse over time.
A person with COPD is likely to experience episodes in which their routine symptoms suddenly become worse. These attacks are known as COPD exacerbations.
Exacerbations may require different drugs, hospitalization, or ventilator support until a doctor can control the flare.
In some instances, a person might need lung surgery, such as a transplant, to manage COPD. However, a transplant is only appropriate for a small number of individuals with COPD.
Hospice and palliative care
Hospice and palliative care services can provide significant support in end stage COPD.
Palliative care services can provide specialist assistance to reduce symptoms whenever possible. They also offer support to the family and make the person's quality of life and comfort a priority.
Hospice care is for those whose symptoms indicate that COPD may soon be fatal.
Examples of these symptoms can include:
- oxygen dependence
- experiencing one or more hospitalizations related to COPD within a year
- weight loss, muscle wasting, or decreasing ability to perform daily activities
- an age of 70 years or older
- having other health concerns that may reduce lifespan, such as heart disease, kidney disease, or liver problems
- having an FEV1 that is less than 30% of the predicted value
Many insurance companies cover hospice and palliative care services. A doctor can advise about available options.
There is no cure for COPD, but people can take steps to make living with COPD more manageable.
- Getting the flu shot every year and asking the doctor about the two types of pneumonia vaccines and the tetanus vaccine, which includes protection against whooping cough.
- Making and keeping all necessary doctor's appointments that relate to lung health.
- Participating in a COPD exercise training program in which specialist therapists give training in breathing techniques that increase exercise ability.
- Reducing exposure to tobacco smoke, chemical irritants, and any other pollution source.
- Seeking treatment at once if signs of a lung infection develop, such as fever.
- Taking action to stop smoking, which exacerbates breathing difficulties.
- Taking all COPD medication that a doctor prescribes and using inhalers as they direct.
How to support a person with COPD
In the late stages of COPD, a person may have difficulty doing physical activities of any kind. They may not be eating enough food due to breathlessness and long, tiring coughing spells.
In the later stages, a person with COPD may rely heavily on family or friends for assistance with daily activities.
Family or friends can help a person with COPD by:
- Keeping a list of current medications, vitamins, and supplements, including the name, dose, and timing of the medicines.
- Identifying symptoms that indicate a COPD exacerbation or other conditions that require immediate medical attention.
- Accompanying the individual to any necessary doctors' appointments or rehabilitation sessions.
- Providing social support through meals and companionship and making changes to activities and outings whenever possible.
It may also help to hold a "family meeting" to divide up the assistance responsibilities. This could include daily chores, medication management, and taking a person to appointments.
Dividing responsibilities can help to reduce caregiver fatigue and help to prevent loneliness and isolation.