Chronic obstructive pulmonary disease (COPD) is a progressive disorder with mild symptoms that get worse over timeand there's no cure. Lifestyle changes and treatments, however, can slow it down. In 2000, 3.9% of the U.S. population between the ages of 25–44 were living with COPD; that number was 7.7% for those between ages 55–64, and 9.5% in people over 74 years of age.
While smoking is a major risk factor, more than 15% of people who develop COPD have never smoked. Specialists like Neil Schachter, MD, a professor of pulmonary medicine and the medical director of the respiratory care department at Mount Sinai Medical Center in New York City, point to pollution, dust, poor air quality, and secondhand smoke as other significant risk factors. Knowing both the risks and symptoms to watch, experts say, can help prevent the disease and slow its progression.
COPD kills more than 100,000 Americans each year, and it is the fourth leading cause of death in the United States.
If you're in your 20s or 30s
A diagnosis of COPD is rare at this age. “Although we dont see COPD in children, we do realize now that children who have asthma may be at risk of COPD later in life because of the [lung changes] that result from asthma,” explains Dr. Schachter. Whether you think you're at risk or not, people under 40 can reduce their risk of COPD by avoiding cigarette smoke, dust, and pollution.
At this age, there is one especially vulnerable groupthose with a rare genetic disorder called alpha-1 antitrypsin deficiency. Only about 100,000 people in the United States have it, but it makes the lungs (and liver) incredibly sensitive to damage and can result in an under-30 diagnosis of COPD (even in otherwise healthy nonsmokers).
The problem is that many people don't know they have the gene until COPD has been diagnosed. However, if you have family members with COPD, you are at greater risk of being a gene carrier.
Bartolome Celli, MD, a professor of medicine in the pulmonary division of the Tufts University School of Medicine, in Boston, recommends that parents with COPD get tested first to check for deficiency; if they have it, their children should get checked. If you have the deficiency, says Dr. Celli, you can help prevent lung problems by avoiding dusty and smoky environments, eating a healthy diet, and getting vaccinations.
Whether you have a genetic predisposition or not, experts agree that the best way to prevent COPD is to avoid smoking, which can set the stage for a COPD diagnosis in your 40s and 50s. Smoking is responsible for about 75% of COPD deaths, according to the Centers for Disease Control and Prevention.
If you're in your 40s or 50s
The first thing you should do? Quit smoking. Research shows that the progression of COPD can be slowed in patients who quit the habit. If you do have COPD, Dr. Schachter recommends revamping your home to be as dust- and pollutant-free as possible: Use HEPA air filters; ditch dust-collecting wall-to-wall carpeting, space heaters, and dust ruffles; stop using your fireplace; fix areas with water damage that can breed mold; and limit contact with pets. “All of these things add up, and since people are exposed for many years, they can cause significant disease,” says Dr. Schachter. Of course, staying healthy with proper nutrition and a diet rich in antioxidants can also play a role in delaying the conditions progression, he adds.
At this age, patients often begin showing COPD symptoms such as chronic cough, wheezing, and excess phlegm. Symptoms sometimes mimic or overlap with asthma, and its important to get a correct diagnosis for the best treatment. “About 25% of people diagnosed with COPD are asthmatics who have experienced lung damage,” says Dr. Schachter.
According to Dr. Celli, other treatment options at this stage include pulmonary rehabilitation, which includes exercise training and breathing education. Medication can help too; a recent study showed that certain COPD therapies may slow down the decline in lung function.
If you're in your 60s and beyond
This is the age when COPD can hit the hardest and cause the most disability. If you're in your 60s or older, COPD symptoms can increase in frequency and severity: Coughing, wheezing, shortness of breath, and weight loss are some of the common complaints. In some severe cases, you might also experience headaches, bloating, swelling in the legs, and confusion.
At this stage, its important to protect yourself against colds and other respiratory tract infections. Infections such as pneumonia can cause a sudden worsening of symptoms, known as a COPD exacerbation, which can be life-threatening. (In addition to the standard COPD symptoms, exacerbations also may be accompanied by fever and fatigue.)
Dr. Schachter recommends getting an annual flu shot and vaccinations that can protect against certain kinds of pneumonia. He also suggests less than 30 minutes of daily exercise to boost your immune system so you are less likely to develop colds and infections.
In addition to a healthy lifestyle and specific COPD medications, oxygen therapy and even lung surgery are sometimes recommended for more serious cases.
But Dr. Celli says that the best medicine is to maintain a healthy lifestyle and not smoke. “If you catch [COPD] early enough, you can prevent or delay it from progression.”