Handbook of Disease Burdens and Quality of Life Measures pp 2759-2777 | Cite as
Quality of Life Measures in Elderly Patients with Chronic Obstructive Pulmonary Disease: Japanese Perspectives
Chronic obstructive pulmonary disease (COPD) is a common disease with increasing prevalence, which tends to show accelerated progression in patients over 65 years old, consequently becoming a major public health problem among elderly populations worldwide. Patients experience a progressive deterioration up to end-stage COPD, characterized by airflow limitation, a severely limited and declining performance status with chronic respiratory failure, advanced age, and various comorbidities due to systemic manifestations. These are mainly attributed to a delay in diagnosis, leading to additional and unexpected comorbidities during the clinical course. These comorbidities can be divided into three major groups: one is a COPD-specific group such as lung cancer; the second group comprises comorbidities generally observed at an advanced age, such as aspiration pneumonia or cognitive impairment; and the third group is made up of a mixture of these, such as osteoporosis, stroke, or ischemic heart disease.
The majority of elderly patients with COPD are managed by primary care physicians who still may not be aware of the recent clinical guidelines; thus, these patients are unlikely to receive proper management in the long term. The culmination of a delayed clinical diagnosis and poor management results in the reduction of activities of daily living ( ADL), repeated exacerbations, a poor quality of life (QOL), and high mortality rate in the elderly with COPD, leading to an increasing socio-economic burden. The management of COPD in elderly patients requires multidisciplinary holistic care with a comprehensive approach based on home respiratory care. In this regard, the role of primary care cannot be overestimated, and cooperation between specialist groups and primary care physicians, along with the support of local health care professionals, is critical. Therefore, treatment improvements and a team approach regarding COPD and its comorbidities are urgently needed in terms of health care for elderly COPD patients in our aging society.
We have described problems concerning elderly COPD patients through our experiences in Japan, particularly from the aspect of the health-related QOL and its perspectives.
KeywordsChronic Obstructive Pulmonary Disease Chronic Obstructive Pulmonary Disease Patient Home Oxygen Therapy Home Mechanical Ventilation Japanese Respiratory Society
List of Abbreviations:
6-minute walking distance
pre-interview questionnaire with 11 questions
activities of daily living
American Thoracic Society
breathing problems questionnaire
chronic obstructive pulmonary disease
chronic respiratory questionnaire
forced expiratory volume in 1 s
gastroesophageal reflux disorders
Global initiative for Chronic Obstructive Lung Disease
home oxygen therapy
health-related quality of life
instrumental activities of daily living
international classification of functioning, disability, and health
international classification of impairments, disabilities, and handicaps
lung volume reduction surgery
oxygen cost diagram
obstructive sleep apnea syndrome
quality of life
quality of life for respiratory illness questionnaire
- QOL scale
questionnaires for quality of life using a linear analog scale
36-item short-form health survey
St George’s respiratory questionnaire
sickness impact profile
upper respiratory infection
visual analogue scale
World Health Organization
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