Living Well & Long -- Will COPD Life Expectancy Permit This?
A COPD diagnosis can feel like a death sentence was just handed out to you or your loved one. And you're not wrong to have this reaction -- after all, COPD is a progressive and terminal condition, at least eventually. But the truth is, people often live for many years with COPD and those years are often high quality too.
So, you might be wondering, what exactly will be the life expectancy after a COPD diagnosis?
First off, I just want to make the point that it is IMPOSSIBLE to predict life expectancy for anyone, whether they have COPD, cancer or any other disease, with 100% accuracy. We've all heard stories of people who overcame the most dire prognoses, as well as people who seemed perfectly healthy one day and dropped dead the next. But, that being said, healthcare professionals do have various tools they use to help them be as accurate as possible.
The BODE Index is a tool that is used to predict COPD life expectancy. It scores the person who has COPD in four different areas. Those scores are added up and a BODE score derived, which will give some estimate of life expectancy. Is it 100 percent right all the time? No, but it has been proven to provide an pretty good idea of how long COPDers might live and also to be more accurate than spirometry (FEV1) alone.
BODE Index Criteria
The four criteria, which are rated from zero up to three, are added together. The higher the total, the sooner you are likely to die from COPD. These are the criteria used in the BODE Index:
Airway obstruction, as measured by predicted FEV1 (forced expiratory volume) via spirometry.
Activity tolerance, as measured by the 6-minute walk test.
Dsypnea, a measure of breathlessness related to activity.
Body weight & build, as measured by Body Mass Index (BMI).
Let's look at each of these factors in more depth.
COPD causes a narrowing and loss of elasticity in the airways and is the underlying reason for COPD symptoms. With obstruction, it is difficult for you to breathe in the air you need to live. But in the early stages of COPD, this obstruction is often so mild you barely notice symptoms, except during intense periods of activity.
However, a test called spirometry was developed that can often pick up changes in the airways before you start noticing severe symptoms. Spirometry measures the volume and force of air as it is exhaled from your lungs. You are asked to breathe in and then to exhale forcefully into an instrument several times. The force of the air is then monitored and measured and a score, called an FEV1, is given.
The FEV1 scores correlate to BODE Index scores as follows:
- FEV1 > 64% = 0
- FEV1 50-64% = 1
- FEV1 36-49% = 2
- FEV1 < 36% = 3
Many studies exist that show that the FEV1 is a good predictor of COPD life expectancy all by itself. But recent studies suggest that using it along with the next three factors is even more accurate.
As you know, as time goes on, COPD can have a huge impact on quality of life and a big reason for this is how it affects a person's ability to tolerate activity and movement. I know this has been one of the most telling symptoms of my mother's gradual deterioration, her increasing difficulty with doing even basic daily living tasks.
The 6-Minute Walk Test is designed to measure this factor scientifically. The test, usually done under supervision on a treadmill, measures distance walked, as well as the patient's rating for degree of shortness of breath while walking.
Here's how your results will correspond with the BODE Index score:
- Walks > 349 meters = 0
- Walks 250-349 meters = 1
- Walks 150-249 meters = 2
- Walks < 150 meters = 3
Dsypnea is a fancy medical term that basically means shortness of breath. Researchers now realize that it is an important component in evaluating current COPD status. I have noticed that my mother has progressed from having no visible dyspnea when she was first diagnosed with COPD to having severe dsypnea even when just walking down the hall.
Dsypnea is measured mainly by what a person with COPD reports, and correlates with the BODE Index in the following ways:
- Dyspnea Index 0-1 (None, except during strenuous exercise) = 0
- Dyspnea Index 2 (Short of breath when walking up a short hill) = 1
- Dyspnea Index 3 (Dsypnea limits walking pace and requires stops to catch breath) = 2
- Dyspnea Index 4 (Stops to catch breath after walking 100 meters or 328 feet on level ground) = 3
- Dyspnea Index 5 (Prevents leaving house and performing Activities of Daily Living) = 3
Body Mass Index (BMI)
You might think the concern here would be obesity or being overweight, and it's true, those conditions are not good for people who have COPD. Being even a few pounds overweight puts you at risk for all sorts of health problems, including heart disease and diabetes.
But it's actually people who are too thin that are at a higher risk of reduced COPD life expectancy. BMI measures degree of body fat by comparing weight and height. These BMI measurements correlate to the BODE Index as follows:
- BMI > 21 = 0
- BMI < 21 = 1
I talked about strategies for keeping weight on in this post:
As you can see, predicting life expectancy in people with COPD can be a pretty complex process. Talk with your doctor about the information in this post and to get his/her take on life expectancy. And meanwhile, live the healthiest lifestyle possible