Disability in Older Adults with COPD: Prevalence, Assessment, and Influencing Factors - A Scoping Review

Chronic obstructive pulmonary disease (COPD) is highly prevalent in older adults. Symptoms such as dyspnea impair daily function and increase the risk of disability. However, no comprehensive synthesis of disability prevalence, assessment tools, and associated factors in this population exists. Therefore, this scoping review aims to identify the prevalence, assessment tools, and influencing factors of disability in this population to inform future interventions. We searched Web of Science, PubMed, Embase, Cochrane Library, CNKI, Wanfang, VIP, and China Biomedical Literature Database from inception to October 31, 2025. Two researchers independently screened, extracted, and analyzed data according to predefined criteria. Twelve studies were included, most of which used cross-sectional designs. These studies reported a wide range of disability prevalence among older adults with COPD (15.00% to 97.00%), reflecting significant heterogeneity across studies. Multiple assessment tools were used; the Katz Index and the Elderly Disability Assessment Scale (EDAS) were the most common. However, few tools had been specifically developed or validated for this population in China. Sociodemographic, disease-related, and psychosocial variables were identified as the main influencing factors. In conclusion, disability in older adults with COPD is a multifactorial condition, and variability in prevalence estimates is largely driven by differences in assessment tools. The predominance of cross-sectional designs precludes causal inference and highlights the need for more rigorous study designs. Future research should focus on developing and prospectively validating COPD-specific assessment tools for mainland Chinese populations, conducting longitudinal studies to clarify disability trajectories, and integrating quantitative and qualitative methods to develop multidimensional intervention strategies.