Quality of Life Measures in Elderly Patients with Chronic Obstructive Pulmonary Disease: Japanese Perspectives

  • K. Kida
  • T. Motegi
  • T. Ishii
  • K. Yamada
Reference work entry


 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.


Chronic Obstructive Pulmonary Disease Chronic Obstructive Pulmonary Disease Patient Home Oxygen Therapy Home Mechanical Ventilation Japanese Respiratory Society 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations:


6-minute walking distance


pre-interview questionnaire with 11 questions


activities of daily living


airways questionnaire


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


 home mechanical ventilation


health-related quality of life


instrumental activities of daily living


international classification of functioning,  disability, and health


international classification of impairments, disabilities, and handicaps


 long-term oxygen therapy


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


self-administered standardized


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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Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • K. Kida
    • 1
  • T. Motegi
    • 1
  • T. Ishii
    • 1
  • K. Yamada
    • 1
  1. 1.Department of Pulmonary MedicineInfection, and Oncology, Respiratory Care Clinic, Nippon Medical SchoolTokyoJapan

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