Characterization of bronchiectasis in the elderly

Abstract

Introduction. Although bronchiectasis particularly affects people 65 years of age, data describing clinical characteristics of the disease in this population are lacking. This study aimed at evaluating bronchiectasis features in older adults and elderly, along with their clinical outcomes.Methods. This was a secondary analysis of six European databases of prospectively enrolled adult outpatients with bronchiectasis. Bronchiectasis characteristics were compared across three study groups: younger adults (18-65 years), older adults (66-75 years), and elderly (and >76 years). 3-year mortality was the primary study outcome.Results. Among 1,258 patients enrolled (median age: 66 years; 42.5% males), 50.9% were >65 years and 19.1 >75 years old. Elderly patients were more comorbid, had worse quality of life and died more frequently than the others. Differences were detected among the three study groups with regard to neither the etiology nor the severity of bronchiectasis, nor the prevalence of chronic infection with P. aeruginosa. In multivariate regression model, age (OR: 1.05; p-value: <0.0001), low BMI (OR: 2.63; p-value: 0.02), previous hospitalizations (OR: 2.06; p-value: 0.006), and decreasing FEV1 (OR: 1.02; p-value: 0.001) were independent predictors of 3-year mortality, after adjustment for covariates. Conclusion.Bronchiectasis does not substantially differ across age groups. Poor outcomes in elderly patients with bronchiectasis might be directly related to individual's frailty that should be further investigated in clinical studies.were used as appropriate. The association between 3-year mortality and collected variables was evaluated using uni-and multi-variate logistic regressions reporting odds ratios (OR) and 95% confidence intervals [CI]. Age and m-BSI scores were divided in tertiles, while CCI score was dichotomized (i.e., <1 vs. >2), according to their distribution. The covariates were chosen with a priori-selection based on previous research and clinical rationale (i.e., independent association with mortality in elderly patients with respiratory diseases). The calculated p-values were twotailed, with values less than 0.05 considered statistically significant.

Etiology and characteristics of patients with bronchiectasis in Taiwan: a cohort study from 2002 to 2016

“…The prevalence of bronchiectasis increased with patient age in previous studies [1,2]. Likewise, we observed that 50% of patients in the bronchiectasis cohort were over 65 years old [26]. Increased age is considered a risk factor for bronchiectasis [27].…”

Comparative risks of chronic inhaled corticosteroids and macrolides for bronchiectasis

“…The study cohort is typical of the older population (⩾65 year old) in the USA, which includes ∼75% all bronchiectasis patients, in contrast to Europe where 50% of all bronchiectasis patients are ⩾65 years old [30,31]. The proportion of female patients in each treatment group (67% ICS and 73% macrolide) was higher than reported in the UK (58%), but similar to the overall population of adults with bronchiectasis in the USA (67%) [2,30].…”

Psychometrics of health-related quality of life questionnaires in bronchiectasis: a systematic review and meta-analysis

“…Studies reporting SGRQ total scores were able to discriminate based on demographics (Bellelli et al, 2016, disease severity (Chalmers et al, 2014, Eshed et al, 2007, Martinez Garcia et al, 2005, exacerbations (Altenburg et al, 2016, Murray et al, 2009a, Martinez Garcia et al, 2005, Guan et al, 2014, Brown et al, 2019, bacteriology (Chalmers et al, 2014, Martinez Garcia et al, 2005, Hill et al, 2015a, Araujo et al, 2018, Brown et al, 2019, Basavaraj et al, 2019, sputum volume (Chan et al, 2002, Martinez Garcia et al, 2005, dyspnoea (Chalmers et al, 2014, chronic rhinosinusitis (Guilemany et al, 2009), sleep quality (Gao et al, 2014a), anxiety and depression (Gao et al, 2018) and exercise capacity (Guan et al, 2015a). Studies reporting SGRQ domain scores were able to discriminate based on disease severity (McDonnell et al, 2016, Eshed et al, 2007, exacerbations (Murray et al, 2009a, Guan et al, 2015b, bacteriology (Wilson et al, 1997a), sputum volume (Chan et al, 2002), chronic rhinosinusitis (Guilemany et al, 2009), wheeze (Wilson et al, 1997a), sleep quality (Gao et al, 2014a), and exercise capacity (Guan et al, 2015a).…”