Clinical features of chronic obstructive pulmonary disease in the elderly.

Abstract

Analysis of randomized, retrospective and prospective clinical, case-control, and observational studies revealed the following main features of COPD in the elderly: (1) COPD is a complex and common condition in elderly patients, characterized by high rates of disturbing symptoms, significant risk of cognitive and functional decline, disease progression,frequent use of health care, extremely difficult treatment and increased mortality. (2) The elderly have an increased prevalence of COPD: in subjects aged 65 years and over, it represents 14,2% (from 11,0% to 18,0%), compared to 9,9% (from 8.2% to 11.8%) in those aged 40 and over. (3) Simultaneously with the 2-4 times higher prevalence of COPD, the elderly patients, especially those aged 75 years or older, also have a higher burden of the disease: frequency, severity and impact of symptoms significantly higher. higher, tolerance to effort and lower daily activities, higher incidence of severe acute  exacerbations and higher prevalence of systemic comorbidities. (4) COPD acute exacerbations and comorbidities have poorer results in elderly patients, fact manifested by an increased rate and duration of the hospitalization, an increased rate of repeted hospitalizations and a higher mortality rate. (5) COPD is a multifaceted condition that involves more than just obstruction of the airflow. Systemic inflammation contributes to the development of systemic effects (loss and dysfunction of skeletal muscle, osteoporosis, anemia, cachexia, neurocognitive dysfunction). (6) Multidimensional assessment and multidisciplinary intervention, well recognized in the geriatric population, should be extended to patients with COPD.