A Guide to COPD: What To Expect Based on Your Age

Prevention, lifestyle changes, treatments, and awareness can help you cope with this lung condition no matter what your age.

Chronic obstructive pulmonary disease (COPD) is a common long-term lung condition caused by smoking and other factors. It is usually diagnosed after age 40, but some people have it for years without realizing it. No matter how old you are when you're diagnosed, knowing what to expect from COPD throughout your life can help you manage it. Lifestyle changes and treatments can slow its course and make it easier to live with.

What Is COPD?

COPD is an umbrella term that refers to a group of conditions, mainly emphysema and chronic bronchitis, that make breathing more difficult. Emphysema involves damage to the air sacs in the lungs, and chronic bronchitis involves inflammation of the airways. Both are commonly caused by smoking and share other risk factors, symptoms, and treatments, and many people have both. Doctors are now using the term COPD to refer to them together.

In 2013, 6.4% of American adults reported a diagnosis of COPD, according to research conducted by the Centers for Disease Control and Prevention (CDC). It kills more than 100,000 Americans each year and is the fourth leading cause of death in the United States.

Symptoms include coughing, wheezing, excess phlegm, and shortness of breath. They are mild in the beginning, but get worse over time.

Risk Factors and Age of Onset

Smoking is the biggest risk factor—about 85 to 90% of cases of COPD are caused by cigarette smoking, according to the American Lung Association.

But some 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, pointed to exposure to pollution, dust, poor air quality, and secondhand smoke as other significant risk factors.

According to the National Library of Medicine, COPD is a long-term condition, and it's most commonly diagnosed after the age of 40. It can emerge in early adulthood in some people, though, particularly those with a genetic predisposition. A history of asthma can also increase the risk.

In addition, women are more likely than men to have COPD and are more likely to die as a result, according to the CDC.

Learn what to expect regarding COPD risk at different stages in your life, and get advice on prevention and management.

COPD in Your 20s or 30s

A diagnosis of COPD is rare in those under 40, but certain people have a higher risk of developing it now or later. If you had asthma as a child, your chances of developing COPD as an adult may be higher. Even though COPD itself isn't seen in children, doctors now realize that children who have asthma may be at risk of COPD later in life as a result of the lung changes it causes, Dr. Schachter said.

There is also one rare genetic disorder known as alpha-1 antitrypsin (AAT) deficiency that can make people vulnerable to COPD as early as their 20s or 30s, and many people don't know they have it until COPD has been diagnosed, according to the National Heart, Lung, and Blood Institute.

AAT is a protein that your liver makes to protect your lungs, and the deficiency makes a person's lungs very sensitive to damage. If you have family members with COPD, you are at greater risk of being a gene carrier. Bartolome Celli, MD, a leading COPD expert and professor of medicine at Harvard Medical School, said that people with COPD should get tested for ATT deficiency if they have children. If they turn out to have it, their children should then get tested.

Adults in their 20s and 30s can take several steps to minimize their risk of COPD, particularly if they're in a higher risk category.

Avoid smoking. Experts agree that this is the best way to prevent COPD.

Make other healthy lifestyle choices. Avoid environmental dust and smoke, eat a healthy diet, and get recommended vaccines to help protect against respiratory illness, said Dr. Celli.

When You're in Your 40s or 50s

At this age, patients often begin showing COPD symptoms such as chronic cough, wheezing, and excess phlegm. The symptoms are similar to those of asthma, and there is a lot of overlap between the two conditions. One-third of people with COPD also have asthma symptoms, according to a study published in the BMJ in February 2017.

This is the age range when many people are first diagnosed, which is an important step for getting the best treatment. If you are diagnosed with COPD, there are things you can do to slow the progression and ease your symptoms.

Quit smoking. This is the most important step you can take, according to the COPD Foundation.

Reduce dust and pollutants in your home. Dr. Schachter recommended the following:

  • Use HEPA air filters.
  • Remove wall-to-wall carpeting, which collects dust. Ditto for dust ruffles.
  • Stop using your fireplace.
  • Fix areas with water damage that can breed mold.
  • Limit contact with pets.

"All of these things add up over time and can cause significant disease," said Dr. Schachter.

Eat a healthy diet rich in antioxidants. This can also play a role in delaying the condition's progression, Dr. Schacter added.

Explore treatment options. According to Dr. Celli, options at this stage include pulmonary rehabilitation, which includes exercise training and breathing education. Medication can help too.

When You're in your 60s or Older

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 common complaints. In some severe cases, you might also experience headaches, bloating, swelling in the legs, and confusion.

At this stage, it becomes increasingly important to ease the burden of symptoms.

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 recommended getting an annual flu shot and vaccinations that can protect against certain kinds of pneumonia.

Exercise gently. Dr. Schacter also suggested less than 30 minutes of daily exercise to boost your immune system so you are less likely to develop colds and infections.

Consider more specialized therapies. In addition to lifestyle changes and specific COPD medications, oxygen therapy and even lung surgery are sometimes recommended for more serious cases. Talk to your healthcare provider to learn more.

But Dr. Celli said 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."

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