Risk of over-diagnosis of COPD in asymptomatic elderly never-smokers

Abstract

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) has defined stage 1 chronic obstructive pulmonary disease (COPD) as forced expiratory volume in one second/forced vital capacity (FEV₁/FVC)% 80%. Stage 2 has been defined as FEV₁/FVC 1% pred of 70 yrs in Bergen, Norway. A respiratory questionnaire was mailed to a random sample of 2,871 persons aged>70 yrs. In a random, well-defined subgroup of 208 never-smoker respondents with no current respiratory disease and significant dyspnoea or heart disease/hypertension complicated with dyspnoea, 71 were able to perform an acceptable spirometry. Approximately 35% of these healthy, elderly never-smokers had an FEV₁/FVC% of 80 yrs ∼50% would be classified as having COPD and approximately one-third would have an FEV₁of 1was consistently 70 yrs. The criteria used to define the various stages of chronic obstructive pulmonary disease need to be age-specific.