title: Epidemiology of Chronic Obstructive Pulmonary Disease (COPD) in Aging Populations.
abstract: Current epidemiologic practice evaluates COPD based on self-reported symptoms of chronic bronchitis, self-reported physician-diagnosed COPD, spirometry confirmed airflow obstruction, or emphysema diagnosed by volumetric computed chest tomography (CT). Because the highest risk population for having COPD includes a predominance of middle-aged or older persons, aging related changes must also be considered, including: 1) increased multimorbidity, polypharmacy, and severe deconditioning, as these identify mechanisms that underlie respiratory symptoms and can impart a complex differential diagnosis; 2) increased airflow limitation, as this impacts the interpretation of spirometry confirmed airflow obstruction; and 3) "senile" emphysema, as this impacts the specificity of CT-diagnosed emphysema. Accordingly, in an era of rapidly aging populations worldwide, the use of epidemiologic criteria that do not rigorously consider aging related changes will result in increased misidentification of COPD and may, in turn, misinform public health policy and patient care.
authors.affiliation: a 1 Veterans Affairs Clinical Epidemiology Research Center , West Haven , Connecticut , USA.|b 2 Yale School of Medicine, Department of Internal Medicine , New Haven , Connecticut , USA.
authors.forename: Carlos A Vaz
authors.initials: CA
authors.lastname: Fragoso
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D014943:Global Health; D006801:Humans; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology*; D015996:Survival Rate / Q000639:trends
keywords: COPD; GOLD; aging; epidemiology; spirometry