Common geriatric conditions and disabilities in older persons with chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is one of the most prevalent chronic diseases among older persons worldwide and the rapid increase in commonly associated COPD-disabilities requires urgent awareness among healthcare professionals. The presence of pulmonary and extrapulmonary comorbidities is highly prevalent among COPD patients and complicates treatment management, especially in advanced age. Some of the most common geriatric conditions in COPD patients lead to respiratory function decline, physical function impairment with limited physical performance, cognitive decline, and depression. Unfortunately, the activation of each component may lead to the progression of the other, which, if not corrected, will lead to critical clinical outcomes such as disability (as seen by the worsening of each condition) and death.

Studies in older persons with COPD have shown that disability is mainly due to the severity of comorbidities that have been shown to significantly impact treatment options and the prognosis for such individuals. In addition to spirometric functional parameters, exercise performance and efficacy of specific therapeutic interventions may be useful indicators for overall health status and outcomes. The scientific literature underlines the necessity to use additional parameters other than spirometry for COPD patient monitoring.

As disability is a growing phenomenon in COPD and substantially impacts patient perception of the disease, we will highlight the recent literature regarding the importance of common geriatric conditions leading to disability in older COPD patients. In particular, we will discuss the impact of the following conditions in older patients with COPD: respiratory function decline, physical function impairment, and mood disorders. Clinical use for measuring such parameters in COPD elderly will aid in identifying those at risk for severe clinical decline.