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Life Expectancy in Chronic Obstructive Pulmonary Disease
Surya P Bhatt1,2, Yifei Sun3, Yuhan Wang3
1Center for Lung Analytics and Imaging Research, University of Alabama at Birmingham.
JAMA Internal Medicine
|May 17, 2026
Summary
Chronic obstructive pulmonary disease (COPD) significantly reduces life expectancy and increases years of life lost (YLL), even in never-smokers. Disease severity directly correlates with greater YLL, highlighting the urgent need for better COPD management and prevention strategies.
Area of Science:
- Pulmonary Medicine
- Epidemiology
- Public Health
Background:
- Chronic obstructive pulmonary disease (COPD) is a major cause of mortality, with a concerning rise in age-standardized death rates.
- Accurate estimations of life expectancy and years of life lost (YLL) due to COPD are crucial for patient care and policy development but are currently lacking.
Purpose of the Study:
- To investigate the association between COPD and reduced life expectancy.
- To determine if COPD-related YLL correlate with disease severity.
Main Methods:
- Utilized data from the National Heart, Lung, and Blood Institute (NHLBI) Pooled Cohorts Study, encompassing 45,886 participants.
- Employed a parametric proportional hazards model with a Gompertz baseline hazard function to estimate survival and life expectancy by Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage.
- Calculated YLL by comparing individuals with COPD to those without airflow obstruction, adjusting for various demographic and health factors.
Main Results:
- COPD was present in 17.6% of participants (8,058 individuals).
- Mean life expectancy at age 65 for individuals without COPD was 21.5 years, decreasing significantly with GOLD stage (e.g., 10.7 years for GOLD stage 4).
- YLL increased with COPD severity, with GOLD stage 4 showing 7.12 YLL. YLL for GOLD stages 2-4 were comparable to or exceeded those for hypertension, diabetes, obesity, and smoking.
Conclusions:
- COPD is definitively associated with a lower life expectancy.
- The study demonstrates a clear correlation between COPD severity and increased YLL.
- These findings underscore the substantial burden of COPD and its impact on longevity, even in non-smokers.
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