There’s no one-size-fits-all answer when it comes to predicting someone’s life span with COPD. A lot depends on your age, health, lifestyle, and how severe the disease was when you were diagnosed, plus the steps you've taken to lessen the damage afterward.
"COPD is a disease with a lot of moving parts," says Albert A. Rizzo, MD, chief medical officer for the American Lung Association. "It's not a death sentence by any means. Many people will live into their 70s, 80s, or 90s with COPD.”
But that’s more likely, he says, if your case is mild and you don’t have other health problems like heart disease or diabetes. Some people die earlier as a result of complications like pneumonia or respiratory failure.
COPD Severity and Life Expectancy
Doctors use a classification system called the Global Initiative on Obstructive Lung Disease (or GOLD) system to determine how severe your COPD is. It's based on how much air you can forcefully exhale in 1 second after blowing into a plastic tube called a spirometer. You’ll also hear this called a forced expiratory volume (FEV1) test.
The classifications are based on results for an adult your same age, gender, and ethnic group but without COPD. So if your airflow was 80% of someone's airflow who doesn’t have COPD, you’d be at GOLD or Stage 1. There four stages:
- GOLD 1: Mild COPD (FEV1 of 80% or more)
- GOLD 2: Moderate COPD (FEV1 50%-79%)
- GOLD 3: Severe emphysema/chronic bronchitis (FEV1 30%-49%)
- GOLD 4: Very severe COPD (FEV1 less than 30%)
In general, the higher your number on the GOLD system, the more likely you are to have problems with or even die from COPD.
Symptoms and Severity
Do you have trouble breathing? Have you been hospitalized for COPD flare-ups, which doctors call exacerbations? Doctors look at your symptoms and put you in one of four categories, A-D. The most serious would be GOLD D (high symptom severity and high exacerbation risk).
Smoking Plays a Role
Smoking is the leading cause of COPD. One study found a small drop in life expectancy (about 1 year) for people with COPD who had never smoked. But there was a much larger reduction for current and former smokers. For men age 65 who smoke, the drop in life expectancy is:
- Stage 1: 0.3 years
- Stage 2: 2.2 years
- Stage 3: 5.8 years
- Stage 4: 5.8 years
This is in addition to the 3.5 years of life all smokers, whether they have COPD or not, lose to the habit.
The same study also found that women who were current smokers and at Stage 2 lost about 5 years of their lives at Stage 3 and 9 years of their lives at Stage 4.
The BODE Index
Another system doctors use to measure life expectancy with COPD is the BODE Index, which stands for:
- Body mass: Are you obese or overweight?
- Airflow obstruction: How much air can you forcefully exhale from your lungs in 1 second (the FEV1 test).
- Dyspnea: How hard is it to breathe?
- Exercise capacity: How far can you walk in 6 minutes?
The higher your BODE score, the greater your risk for death from COPD. This test is considered more accurate than just the FEV1 score.
Can Medication Help?
Right now there aren't any medicines that cure COPD. "We are still looking for drugs that can slow down the disease process itself and reverse inflammation in the airways," Rizzo says. But there are bronchodilators (medications usually taken through inhalers) that can open your airways and improve shortness of breath.
Corticosteroids can help control flare-ups. That's important because more COPD hospitalizations are linked to a higher likelihood of death.
If you’re constantly low on oxygen, your doctor might prescribe supplemental oxygen. You’ll get a device you can take with you anywhere to help you breathe.
And you have to have access to care in the first place. Rizzo says more studies are looking at COPD in terms of gender, age, and socioeconomic status. Someone with COPD who doesn't have access to health care and doesn't have insurance is more likely to have complications and die early, even if their diagnosis is the same as someone from a higher income level.
Early Diagnosis Can Make a Difference
An early diagnosis can also greatly improve your life expectancy. "Probably half the people with COPD had the disease for a number of years before they were diagnosed," Rizzo says. "They didn't bring it to the attention of their physician because they thought the cough and the shortness of breath were related to being overweight, out of shape, and still smoking."
Also, doctors have to diagnose COPD correctly by ordering the right tests, he says.
Rizzo also points to studies under way figure out why some people are more likely to get COPD than others. A study started this year by the National Institutes of Health and supported by the American Lung Association will look at lung function in 25-35-year-olds (lung function reaches its peak in the mid-20s) and figure out what changes over the course of their lifetime. “We want to notice when an individual develops findings of COPD, what may have led to it, and what we can learn from that to improve survival," he says.
Make Lifestyle Changes
While there isn't a drug to take care of COPD, there are many lifestyle changes you can make that will slow disease progression and improve your chances of living a longer life. You can:
- Quit smoking. It’s the most important thing you can do to improve your life expectancy with COPD.
- Avoid secondhand smoke and other things that might irritate your lungs.
- Control your weight.
- Stay up to date with vaccines, including COVID-19, seasonal flu, and pneumonia vaccines.
Once you've been diagnosed with COPD, follow your doctor's advice to stop smoking, exercise, and take any medications prescribed. "And most important, stay active," Rizzo says. "Walking is the best exercise for lungs, so walk on a regular basis."