If you have COPD (chronic obstructive pulmonary disease) yourself or if you are caring for someone who does, maybe you are concerned about life expectancy.
COPD is a chronic lung disease that gets worse over time. Unfortunately, there is no cure for COPD. However, there are treatments that can help to slow down the speed at which the symptoms get worse. Thus, these treatments can improve the quality of life of patients. As with other diseases, experts use different methods to predict how long you might live with COPD.
How is COPD life expectancy determined?
The life expectancy of COPD patients varies greatly because many different factors are involved. For example, some factors are your individual symptoms, your age, your health, and how you rank in the GOLD system. Another important factor is whether you have smoked during your life and, if so, for how long.
In order to assess the severity of COPD, doctors use the Global Initiative on Obstructive Lung Disease (GOLD) system. Specifically, this system uses a forced expiratory volume (FEV1) test to see how much air you can forcefully breathe out in one second after blowing into a spirometer.
According to the GOLD system, there are four stages of COPD:
- Mild COPD = GOLD 1 (More than or equal to 80% FEV1)
- Moderate COPD = GOLD 2 (50-80% FEV1)
- Severe COPD = GOLD 3 (20-50% FEV1)
- Very severe COPD = GOLD 4 (Less than 30% FEV1)
In addition, the GOLD system also considers other factors such as your specific breathing problems and the number of flare-ups you tend to have. Ultimately, the higher your score on the GOLD scale, the lower your COPD life expectancy is likely to be.
What is the COPD BODE scale?
Another scale that’s often used in combination with GOLD is the BODE scale. BODE stands for body mass index, airflow obstruction, dyspnea (breathlessness), and exercise capacity. Specifically, this scale looks at how your COPD affects your life and how you score on different factors, including:
- BMI (body mass index) – as having COPD can cause problems with weight management
- Breathing difficulty level – this shows how much trouble you have with your breathing
- Exercise capacity – a measure of how far you’re able to walk in six minutes, which shows how much physical activity you can manage
- Airflow blockage – the BODE scale also takes into account the results from FEV1 and other lung function tests to assess how much your airflow is blocked.
When all the factors have been considered, you end up with a BODE score of between 0 and 10. People who score 10 have the worst symptoms and are likely to have a shorter life expectancy.
Even though assessment tools for COPD are useful and can help to indicate a likely life expectancy, it’s important to remember that they’re only an estimate.
Is COPD considered a terminal illness?
COPD is not a terminal illness but a chronic disease that gets worse over time . Although there is no cure for COPD, the illness can be successfully managed especially if it’s recognized early.
Studies have shown that the rate at which the lung function of COPD patients decreases can be reduced if a diagnosis is made in the early stages of the disease and if medical treatment starts without delay. Furthermore, lifestyle changes can slow down the speed at which COPD symptoms get worse. For example, one study found that stopping smoking after a COPD diagnosis delayed the worsening of the disease. Even though this was the case at all stages of COPD, earlier actions had the biggest impact.
Can you live 10 or 20 years with COPD?
The exact length of time you can live with COPD depends on your age, health, and symptoms. Especially if your COPD is diagnosed early, if you have mild stage COPD, and your disease is well managed and controlled, you may be able to live for 10 or even 20 years after diagnosis. For example, one study found that people who were diagnosed with mild stage COPD, or GOLD stage 1, had no shorter life expectancy than healthy people.
This is especially so if you don’t smoke: Other research has found that life expectancy with COPD is reduced further for past and current smokers.
People with severe stage COPD, lose about eight to nine years of life expectancy on average .
What can help improve COPD life expectancy?
Quitting smoking can have a positive effect on your life expectancy if you are a smoker and have COPD. For instance, numerous studies suggest that smokers with GOLD stage 1 or 2 (mild and moderate) COPD lose a few years of life expectancy at the age of 65. In addition, it has been shown by studies that people with stages 3 or 4 (severe and very severe) COPD lose from six to nine years of life expectancy because of smoking. Notably, this loss of life expectancy is in addition to the four years of life lost by anyone who smokes.
If you’ve never smoked, you can help yourself by making sure your symptoms are managed well and that you have regular check-ups. For example, routine blood checks can help control inflammation and may help to pick up on potential issues before they worsen.
Simple lifestyle changes such as losing weight, eating healthily, and exercising safely, when possible, can also help you to maintain a good quality of life.
For prople with severe COPD, treatments such as oxygen therapy, lung volume reduction surgery and lung transplants may also help to increase life expectancy.
How do most COPD patients die?
With COPD, everyone’s situation and health are individual and unique and there is no one way to say how patients may die. However, some research has found that for people with mild COPD, the causes of death are often cardiovascular diseases.
In contrast, in cases of severe COPD, research has shown that major causes of death include heart failure, respiratory failure, lung infection, lung embolism, heart arrhythmia, and lung cancer.
While it’s good to stay positive and not focus on dying, if your condition gets worse and becomes very serious, it’s likely that your doctor or nurse will mention palliative and end-of-life care. Moreover, discussing your situation with your family doctor can help you make decisions and take care of your physical, emotional, social, and spiritual needs. As palliative care is both patient and family-centered, it can help prevent and relieve suffering.
At GAAPP, we want to empower patients because everyone deserves to live freely without their symptoms interfering with their lives. Find out more about our Patient Charter here.
Sources
Berry CE, Wise RA. 2010. Mortality in COPD: causes, risk factors, and prevention. COPD. 2010 Oct;7(5):375-82. doi: 10.3109/15412555.2010.510160. PMID: 20854053; PMCID: PMC7273182.
BMJ Best Practice. Chronic obstructive pulmonary disease (COPD). Diagnosis: criteria.
Chen CZ, Shih CY, Hsiue TR et al. 2020. Life expectancy (LE) and loss-of-LE for patients with chronic obstructive pulmonary disease. Respir Med. Oct;172:106132. doi: 10.1016/j.rmed.2020.106132. Epub 2020 Aug 29. PMID: 32905891.
Curtis JR. 2008. Palliative and end-of-life care for patients with severe COPD. European Respiratory Journal. 32: 796-803; DOI: 10.1183/09031936.00126107
Global Initiate for Chronic Obstructive Lung Disease. 2018. Pocket Guide for COPD diagnosis, management and prevention: A guide for health care professionals. 2018 report.
Hadi Khafaji HA, Cheema A. 2019. Heart failure and chronic obstructive airway disease as combined comorbidities. Meta-analysis and Review. Arch Pulmonol Respir Care 5(1): 015-022. DOI: 10.17352/aprc.000037
Hansell AL, Walk JA, Soriano JB. 2003. What do chronic obstructive pulmonary disease patients die from? A multiple cause coding analysis. European Respiratory Journal. 22: 809-814; DOI: 10.1183/09031936.03.00031403
Lung Health Institute. 2016. BODE index and COPD: determining your stage of COPD.
Shavelle RM, Paculdo DR, Kush SJ, et al. 2009. Life expectancy and years of life lost in chronic obstructive pulmonary disease: findings from the NHANES III Follow-up Study. International journal of chronic obstructive pulmonary disease, 4, 137–148.
Vestbo J; TORCH Study Group. 2004. The TORCH (towards a revolution in COPD health) survival study protocol. Eur Respir J. Aug;24(2):206-10. doi: 10.1183/09031936.04.00120603. PMID: 15332386.
Welte T, Vogelmeier C, Papi A. 2015. COPD: early diagnosis and treatment to slow disease progression. Int J Clin Pract. Mar;69(3):336-49.