title: Fifteen-year mortality of patients with asthma-COPD overlap syndrome.
abstract: BACKGROUND
  The coexistence of asthma and chronic obstructive pulmonary disease (asthma-COPD overlap syndrome: ACOS) is increasingly recognized but data about its prevalence and long-term mortality are needed.
  
  
  METHODS
  Prevalence of ACOS and 15-year mortality rates were assessed in 1065 subjects aged >65years, enrolled in the SA.R.A. study, with complete clinical, lung functional and follow-up data. Physical performance, disease-related disability, and health-related quality of life (HRQL) were also evaluated.
  
  
  RESULTS
  ACOS was found in 11.1% of subjects (29.4% of those previously diagnosed with COPD and 19.7% of those with asthma). ACOS was positively associated with impaired physical performance, functional ability, and HRQL. Individuals with ACOS had higher mortality rates than controls (7.17 per 100 person-years; mortality rate ratio: 1.83). After adjustment for the main confounders, the risk of all-cause mortality remained significantly increased in subjects with ACOS (HR: 1.82), COPD (HR: 2.12), and restriction (HR: 2.41), but not asthma.
  
  
  CONCLUSIONS
  Long-term prognosis of ACOS was similar to COPD, and worse than asthma and healthy controls. ACOS had a significant impact on physical performance, functional ability, and HRQL.
authors.affiliation: Biomedical Department of Internal and Specialist Medicine, Section of Pulmonology, University of Palermo, Italy; Division of Pulmonology, ASST Lariana S. Anna Hospital of Como, Italy. Electronic address: claudiosorino@libero.it.
authors.forename: Claudio
authors.initials: C
authors.lastname: Sorino
authors.affiliation: Unit of Geriatrics, University Campus Bio-Medico, Rome, Italy. Electronic address: c.pedone@unicampus.it.
authors.forename: Claudio
authors.initials: C
authors.lastname: Pedone
authors.affiliation: Biomedical Department of Internal and Specialist Medicine, Section of Pulmonology, University of Palermo, Italy. Electronic address: nicola.scichilone@unipa.it.
authors.forename: Nicola
authors.initials: N
authors.lastname: Scichilone
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology*; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D008297:Male; D009026:Mortality; D011379:Prognosis; D016016:Proportional Hazards Models; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology*; D011788:Quality of Life
keywords: Asthma; COPD; Chronic obstructive pulmonary disease; Epidemiology