[Chronic obstructive pulmonary disease (COPD), advanced age, and comorbidities]

Chronic obstructive pulmonary disease (COPD) is a common chronic condition that is often not diagnosed until later in life. In older patients, COPD rarely occurs in isolation but rather in the context of multimorbidity and geriatric syndromes. The aim of this article is to highlight the significance of selected geriatric syndromes for the diagnosis and management of COPD.

In addition to established clusters of comorbidities, geriatric syndromes such as frailty, dementia, dysphagia, and depression play a central role. Frailty is associated with an increased symptom burden, more frequent exacerbations, functional limitations, and higher mortality, and can influence diagnosis and treatment. Cognitive impairments complicate the medical history, pulmonary function testing, and the correct use of inhaled medications. Dysphagia is common and increases the risk of exacerbations as well as reduced treatment adherence. Depression is common in COPD patients and is associated with reduced quality of life and increased hospitalization rates, yet it often goes unrecognized.

The management of older patients with COPD requires a structured geriatric assessment, including screening for frailty, cognitive impairment, dysphagia, and depression. An interdisciplinary, patient-centered approach can help improve treatment outcomes, quality of life, and prognosis.