Highlights
- •ACOS negatively affects physical performance and health-related quality of life.
- •ACOS worsens disease-related disability.
- •Long-term mortality of ACOS is worse than asthma and similar to COPD.
- •After 65 years, 1/3 of COPD patients and 1/5 of asthmatics might have ACOS.
Abstract
Background
The coexistence of asthma and chronic obstructive pulmonary disease (asthma–COPD overlap
syndrome: ACOS) is increasingly recognized but data about its prevalence and long-term
mortality are needed.
Methods
Prevalence of ACOS and 15-year mortality rates were assessed in 1065 subjects aged
>65 years, enrolled in the SA.R.A. study, with complete clinical, lung functional and
follow-up data. Physical performance, disease-related disability, and health-related
quality of life (HRQL) were also evaluated.
Results
ACOS was found in 11.1% of subjects (29.4% of those previously diagnosed with COPD
and 19.7% of those with asthma). ACOS was positively associated with impaired physical
performance, functional ability, and HRQL. Individuals with ACOS had higher mortality
rates than controls (7.17 per 100 person-years; mortality rate ratio: 1.83). After
adjustment for the main confounders, the risk of all-cause mortality remained significantly
increased in subjects with ACOS (HR: 1.82), COPD (HR: 2.12), and restriction (HR:
2.41), but not asthma.
Conclusions
Long-term prognosis of ACOS was similar to COPD, and worse than asthma and healthy
controls. ACOS had a significant impact on physical performance, functional ability,
and HRQL.
Abbreviations:
6MWT (6-min walking test), ACOS (asthma–COPD overlap syndrome), BD (bronchodilator), COPD (chronic obstructive pulmonary disease), GLI (Global Lung Initiative), HRQL (health-related quality of life), LLN (lower limit of normal), PY (person/years), SA.R.A. (SAlute Respiratoria nell'Anziano—Respiratory Health in the Elderly), SGRQ (Saint George Respiratory Questionnaire)Keywords
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Article info
Publication history
Published online: June 26, 2016
Accepted:
June 15,
2016
Received in revised form:
May 23,
2016
Received:
April 4,
2016
Footnotes
☆For all authors, no financial or other potential conflicts of interest exist.
☆☆The study was supported by the Italian Association for the Prevention, Diagnosis, and Treatment of Respiratory Diseases (PreDiCARe).
Identification
Copyright
© 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
