Journal Article

Chronic Obstructive Pulmonary Disease (COPD) as a disease of early aging: Evidence from the EpiChron Cohort

Divo, Miguel J., Marin, Jose M., Prados-Torres, Alexandra, Polverino, Francesca, Bertó, Juan, Casanova, Ciro, Pinto-Plata, Victor M., Celli, Bartolome R., Calderón-Larrañaga, Amaia, Poblador-Plou, Beatriz, Zulueta, Javier J., Cabrera-Lopez, Carlos, Carmona Píréz, Jonás, de-Torres, Juan Pablo, Gimeno-Feliu, Luis A.

2018

Overview

Aging is an important risk factor for most chronic diseases. Patients with COPD develop more comorbidities than non-COPD subjects. We hypothesized that the development of comorbidities characteristically affecting the elderly occur at an earlier age in subjects with the diagnosis of COPD. We included all subjects carrying the diagnosis of COPD (n = 27,617), and a similar number of age and sex matched individuals without the diagnosis, extracted from the 727,241 records of individuals 40 years and older included in the EpiChron Cohort (Aragon, Spain). We compared the cumulative number of comorbidities, their prevalence and the mortality risk between both groups. Using network analysis, we explored the connectivity between comorbidities and the most influential comorbidities in both groups. We divided the groups into 5 incremental age categories and compared their comorbidity networks. We then selected those comorbidities known to affect primarily the elderly and compared their prevalence across the 5 age groups. In addition, we replicated the analysis in the smokers' subgroup to correct for the confounding effect of cigarette smoking. Subjects with COPD had more comorbidities and died at a younger age compared to controls. Comparison of both cohorts across 5 incremental age groups showed that the number of comorbidities, the prevalence of diseases characteristic of aging and network's density for the COPD group aged 56-65 were similar to those of non-COPD 15 to 20 years older. The findings persisted after adjusting for smoking. Multimorbidity increases with age but in patients carrying the diagnosis of COPD, these comorbidities are seen at an earlier age.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adult / Age / Aged / Aged, 80 and over / Aging / Aging (Biology) / Analysis / Atherosclerosis / Biology and Life Sciences / Chronic illnesses / Chronic obstructive lung disease / Chronic obstructive pulmonary disease / Cigarette smoking / Cohort Studies / Comorbidity / Comparative analysis / Computer and Information Sciences / Critical care / Development and progression / Diagnosis / Female / Geriatrics / Health aspects / Health risks / Hospitals / Humans / Lung diseases / Male / Medical records / Medicine / Medicine and Health Sciences / Middle Aged / Mortality / Mortality risk / Network analysis / Obstructive lung disease / Older people / Patients / People and Places / Primary care / Pulmonary Disease, Chronic Obstructive - epidemiology / Pulmonary Disease, Chronic Obstructive - pathology / Pulmonary Disease, Chronic Obstructive - physiopathology / Risk factors / Smoking / Spain / Spain - epidemiology / Subgroups / Womens health