Age distribution of patients treated in hospital for chronic obstructive pulmonary disease.

Introduction

Respiratory symptoms are common in older people. In a study of persons aged 65 or over, 28% reported wheeze and 20% reported dyspnoea at rest within the preceding 12-month period [1]. In a recent report the prevalence of lung disease in current smokers aged over 65 was 8% of men and 7% of women with chronic bronchitis and 14% of men and 5% of women with emphysema [2]. It was also noted that undiagnosed airways obstruction was most likely in women and those with lower income, and was associated with current and former smoking.

Chronic obstructive pulmonary disease (COPD) is primarily a smokers' disease which clusters in families and worsens with increasing age. The disease causes progressive loss of lung function and finally disables the patient. COPD has a long, relatively asymptomatic phase of measurable accelerated decrease in pulmonary function before individuals seek medical attention because of dyspnoea and related symptoms [3]. COPD is usually diagnosed between the ages of 50 and 60 when [FEV.sub.1] is 1-1.51/s and after COPD has become symptomatic it has a poor prognosis [4].

Mortality and morbidity trends are parallel to smoking prevalence. Smoking rates appear to be levelling off or even decreasing among men in developed countries but among women the rates are increasing. Smoking rates are higher in groups that are most difficult to reach by health information: the unemployed and blue-collar workers, the less educated, and minorities [5]. COPD and malignant neoplasm (especially respiratory cancers) are the only disorders which have shown an increasing trend in age-adjusted and proportionate mortality between 1950 and 1986 in the USA [6]. The fact that mortality rate 10 years after diagnosis of COPD is greater than 50% [4] confirms that COPD is a very serious disorder and a lot of care (also in hospital) is needed by symptomatic COPD patients.

The amount of treatment and care needed by COPD cases will be largely determined by the proportion of the aged population. Whatever happens to the age-adjusted rates of the disease, in Western countries with increasingly aged populations, COPD in all its forms is likely to be a persistent problem for a considerable time to come.

The aim of the present research was to study the age distribution of hospitalized COPD patients. …