The Impact of Aging and Smoking on the Future Burden of Chronic Obstructive Pulmonary Disease

Abstract

Chronic obstructive pulmonary disease (COPD) causes extensive disability, primarily among the elderly. On the World Health Organization ranking list of disability-adjusted life years (DALYs), COPD rises from the twelfth to the fifth place from 1990 to 2020. The purpose of this study is to single out the impact of changes in demography and in smoking behavior on COPD morbidity, mortality, and health care costs. A dynamic multistate life table model was used to compute projections for the Netherlands. Changes in the size and composition of the population cause COPD prevalence to increase from 21/1,000 in 1994 to 33/1,000 in 2015 for men, and from 10/ 1,000 to 23/1,000 for women. Changes in smoking behavior reduce the projected prevalence to 29/1,000 for men, but increase it to 25/ 1,000 for women. Total life years lost increase more than 60%, and DALYs lost increase 75%. Costs rise 90%; smokers cause approximately 90% of these costs. The model demonstrates the unavoidable increase in the burden of COPD, an increase that is larger for women than for men. The major causes of this increase are past smoking behavior and the aging of the population; changes in smoking behavior will have only a small effect in the nearby future.

Prevalence of Chronic Obstructive Pulmonary Disease in Kocaeli: An Industrialised City in Turkey

“…Aging and increasing exposure to inhaled particles and gases enhances the COPD risk (2,16 rather by the proposed world population aging than by the proposed variations on the smoking prevalence (17). Accordingly, our data showed that the prevalence of COPD that was stage I or higher increased with age.…”

Economic evaluation and the postponement of health care costs

“…The CDM is a tool to describe the morbidity and mortality effects of risk factors for chronic diseases, including smoking and overweight and has been used for projections of risk factor and disease prevalence and cost effectiveness analysis (van Baal et al, 2006(van Baal et al, , 2007aFeenstra et al, 2001Feenstra et al, , 2005Struijs et al, 2005;Jacobs-van der Bruggen et al, 2007). The model describes the life course of cohorts in terms of changes between risk factor classes and changes between disease states over time.…”

COPD: problems in diagnosis and measurement

“…The combination of recall bias on the part of the patient and diagnostic bias on the part of the physician consequently creates diagnostic uncertainty and potential misdiagnosis of COPD [32]. FEENSTRA et al [33] recently showed that there will be an increase in the burden of COPD between 1994-2015. This will result in a 43% increase in prevalence of COPD for males and a 142% increase for females.…”