Su particular comportamiento en la edad avanzada | 02 JUN 14

Enfermedad pulmonar obstructiva crónica

Las comorbilidades y la edad avanzada modifican la presentación, las características de las exacerbaciones y el tratamiento clásicos de la enfermedad pulmonar obstructiva crónica.
Autor/a: Dres. Raffaele Antonelli Incalzi, Simone Scarlata, Giorgio Pennazza c, Marco Santonico, Claudio Pedone. European Journal of Internal Medicine 25 (2014) 320–328
INDICE:  1.  | 2. Referencias

 [1] CDC. Chronic obstructive pulmonary disease among adults — United States. MMWR 2012;61:938–43.
[2] Geldmacher H, Biller H, Herbst A, Urbanski K, Allison M, Buist AS, et al. The prevalence of chronic obstructive pulmonary disease (COPD) in Germany. Results of the BOLD study. Dtsch Med Wochenschr 2008;133:2609–14.
[3] Stang P, Lydick E, Silberman C, Kempel A, Keating ET. The prevalence of COPD: using smoking rates to estimate disease frequency in the general population. Chest 2000;117:354S–9S.
[4] Ekström MP, Wagner P, Ström KE. Trends in cause-specific mortality in oxygen-dependent chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2011;183:1032–6.
[5] Savale L, Chaouat A, Bastuji-Garin S, Marcos E, Boyer L, Maitre B, et al. Shortened telomeres in circulating leukocytes of patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2009;179:566–71.
[6] Hohensinner PJ, Goronzy JJ, Weyand CM. Telomere dysfunction, autoimmunity and aging. Aging and Disease 2011;2:524–37.
[7] Hoffmann J, Spyridopoulos I. Telomere length in cardiovascular disease: new challenges in measuring this marker of cardiovascular aging. Future Cardiol 2011;7:789–803.
[8] Spyridopoulos I, Hoffmann J, Aicher A, Brümmendorf TH, Doerr HW, Zeiher AM, et al. Accelerated telomere shortening in leukocyte subpopulations of patients with coronary heart disease: role of cytomegalovirus seropositivity. Circulation 2009;120:1364–72.
[9] Lange P, Parner J, Schnohr P, Jensen G. Copenhagen City Heart Study: longitudinal analysis of ventilatory capacity in diabetic and nondiabetic adults. Eur Respir J 2002;20:1406–12.
[10] Nishimura M, Makita H, Nagai K, Konno S, Nasuhara Y, Hasegawa M, et al. Annual change in pulmonary function and clinical phenotype in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2012;185:44–52.
[11] Garcia-Rio F, Dorgham A, Pino JM, Villasante C, Garcia-Quero C, Alvarez-Sala R. Lung volume reference values for women and men 65 to 85years of age. Am J Respir Crit Care Med 2009;180:1083–91.
[12] Lalley PM. The aging respiratory system — pulmonary structure, function and neural control. Respir Physiol Neurobiol 2013;87:199–210 [doi: S1569-9048(13)00091-8].
[13] Incalzi RA, Gemma A, Marra C, Muzzolon R, Capparella O, Carbonin P. Chronic obstructive pulmonary disease. An original model of cognitive decline. Am Rev Respir Dis 1993;148:418–24.
[14] Antonelli-Incalzi R, Corsonello A, Trojano L, Acanfora D, Spada A, Izzo O, et al. Correlation between cognitive impairment and dependence in hypoxemic COPD. J Clin Exp Neuropsychol 2008;30:141–50.
[15] Anthonisen NR, Manfreda J, Warren CP, Hershfield ES, Harding GK, Nelson NA. Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann Intern Med 1987;106:196–204.
[16] Incalzi RA, Fuso L, Serra M, Basso S, Carosella L, Tramaglino LM, et al. Exacerbated chronic obstructive pulmonary disease: a frequently unrecognized condition. J Intern Med 2002;252:48–55.
[17] Celli BR, MacNee W, ATS/ERS Task Force. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J 2004;23:932–46.
[18] Bellia V, Pistelli R, Catalano F, Antonelli-Incalzi R, Grassi V, Melillo G, et al. Quality control of spirometry in the elderly. The SA.R.A. study. SAlute Respiration nell'Anziano = Respiratory Health in the Elderly. Am J Respir Crit Care Med 2000;161:1094–100.
[19] Lindberg A, Bjerg A, Rönmark E, Larsson LG, Lundbäck B. Prevalence and underdiagnosis of COPD by disease severity and the attributable fraction of smoking. Report from the Obstructive Lung Disease in Northern Sweden Studies. Respir Med 2006;100:264–72.
[20] Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur Respir J 2005;26:319–38.
[21] Swanney MP, Jensen RL, Crichton DA, Beckert LE, Cardno LA, Crapo RO. FEV(6) is an acceptable surrogate for FVC in the spirometric diagnosis of airway obstruction and restriction. Am J Respir Crit Care Med 2000;162:917–9.
[22] Enright RL, Connett JE, Bailey WC. The FEV1/FEV6 predicts lung function decline in adult smokers. Respir Med 2002;96:444–9.
[23] Hankinson JL, Crapo RO, Jensen RL. Spirometric reference values for the 6-s FVC maneuver. Chest 2003;124:1805–11.
[24] García-Río F, Pino J M, Dorgham A,Alonso A,Villamor J. Spirometric reference equations for European females and males aged 65–85yrs. Eur Respir J 2004;24:397–405.
[25] Bellia V, Sorino C, Catalano F, Augugliaro G, Scichilone N, Pistelli R, et al. Validation of FEV6 in the elderly: correlates of performance and repeatability. Thorax 2008;63:60–6.
[26] Hankinson JL, Odencrantz JR, Fedan KB. Spirometric reference values from a sample of the general U.S. population. Am J Respir Crit Care Med 1999;159:179–87.
[27] Sorino C, Battaglia S, Scichilone N, Pedone C, Antonelli-Incalzi R, Sherrill D, et al. Diagnosis of airway obstruction in the elderly: contribution of the SARA study. Int J Chron Obstruct Pulmon Dis 2012;7:389–95.
[28] O'Donnell DE, Webb KA. The major limitation to exercise performance in COPD is dynamic hyperinflation. J Appl Physiol 2008;105:753–5.
[29] Berton DC, Reis M, Siqueira AC, Barroco AC, Takara LS, Bravo DM, et al. Effects of tiotropium and formoterol on dynamic hyperinflation and exercise endurance in COPD. Respir Med 2010;104:1288–96.
[30] Fens N, Zwinderman AH, van der Schee MP, de Nijs SB, Dijkers E, Roldaan AC, et al. Exhaled breath profiling enables discrimination of chronic obstructive pulmonary disease and asthma. Am J Respir Crit Care Med 2009;180:1076–82.
[31] D'Amico A, Pennazza G, Santonico M, Martinelli E, Roscioni C, Galluccio G, et al. An investigation on electronic nose diagnosis of lung cancer. Lung Cancer 2010;68:170–6.
[32] Pennazza G, Scarlata S, Santonico M, Chiurco D, D'Amico A, Incalzi RA. Exhaled breath analysis for the monitoring of elderly COPD patients health-state. AIP Conference Proceedings 2011;1362:155–6.
[33] Incalzi RA, Pennazza G, Scarlata S, Santonico M, Petriaggi M, Chiurco D, et al. Reproducibility and respiratory function correlates of exhaled breath fingerprint in chronic obstructive pulmonary disease. PLoS One 2012;7:e45396. 10.1371/journal.pone.0045396.
[34] Mazzone PJ. Exhaled volatile organic compounds as biomarkers for respiratory diseases. Eur Respir Mon 2010;49:130–9.
[35] Dragonieri S, Schot R, Mertens BJA, Le Cessie S, Gauw SA, Spanevello A, et al. An electronic nose in the discrimination of patients with asthma and controls. J Allergy Clin Immunol 2007;120:856–62.
[36] Kanoh S, Kobayashi H, Motoyoshi K. Exhaled ethane. An in vivo biomarker of lipid peroxidation in interstitial lung diseases. Chest 2005;128:2387–92.
[37] FendR, Kolk AHJ, Bessant C, Buijtels P, Klatser PR, Woodman AC. Prospects for clinical application of electronic-nose technology to early detection of Mycobacterium tuberculosis in culture and sputum. J Clin Microbiol 2006;44:2039–45.
[38] Dutta R, Hines EL, Gardner JW, Boilot P. Bacteria classification using Cyranose 320 electronic nose. Biomed Eng Online 2002;1:4.
[39] Humphreys L, Orme RM, Moore P, Charaklias N, Sahgal N, Pont NP, et al. Electronic nose analysis of bronchoalveolar lavage fluid. Eur J Clin Invest 2011;41:52–8.
[40] Bellia V, Battaglia S, Catalano F, Scichilone N, Incalzi RA, Imperiale C, et al. Aging and disability affect misdiagnosis of COPD in elderly asthmatics: the SARA study. Chest 2003;123:1066–72.
[41] Moore WC, Meyers DA, Wenzel SE, Teague WG, Li H, Li X, et al. Identification of asthma phenotypes using cluster analysis in the Severe Asthma Research Program. Am J Respir Crit Care Med 2010;181:315–23.
[42] Antonelli-Incalzi R, Imperiale C, Bellia V, Catalano F, Scichilone N, Pistelli R, et al. Do GOLD stages of COPD severity really correspond to differences in health status? Eur Respir J 2003;22:444–9.
[43] Coultas DB, Mapel D, Gagnon R, Lydick E. The health impact of undiagnosed airflow obstruction in a national sample of United States adults. Am J Respir Crit Care Med 2001;164:372–7.
[44] Antonelli Incalzi R, Pedone C, Pahor M. Multidimensional assessment and treatment of the elderly with COPD. European respiratory society monograph 43, Respiratory diseases in the elderly; 2009. p. 35–55.
[45] Incalzi RA, Pedone C, Onder G, Pahor M, Carbonin PU, GIFA. Gruppo Italiano di Farmacovigilanza (Italian Group for Pharmacological Survey in the Elderly). Predicting length of stay of older patients with exacerbated chronic obstructive pulmonary disease. Aging (Milano) 2001;13:49–57.
327R.A. Incalzi et al. / European Journal of Internal Medicine 25 (2014) 320–328
[46] Ng TP, Niti M, Tan WC, Cao Z, Ong KC, Eng P. Depressive symptoms and chronic obstructive pulmonary disease: effect on mortality, hospital readmission, symptom burden, functional status, and quality of life. Arch Intern Med 2007;167:60–7.
[47] O'Donnel lDE, Revill SM, WebbK A. Dynamic hyperinflation and exercise intolerance in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2001;164:770–7.
[48] Anzueto A. Impact of exacerbations on COPD. Eur Respir Rev 2010;19:113–8. http://
[49] Antonelli-Incalzi R, Ancona C, Forastiere F, Belleudi V, Corsonello A, Perucci CA. Socioeconomic status and hospitalization in the very old: a retrospective study. BMC Public Health 2007;7:227.
[50] Incalzi RA, Corsonello A, Pedone C, Corica F, Carbonin P, Bernabei R, et al. Construct validity of activities of daily living scale: a clue to distinguish the disabling effects of COPD and congestive heart failure. Chest 2005;127:830–8.
[51] Anthonisen NR, Wright EC, Hodgkin JE. Prognosis in chronic obstructive pulmonary disease. Am Rev Respir Dis 1986;133:14–20.
[52] Calverley PM, Anderson JA, Celli B,Ferguson GT,Jenkins C,Jones PW,e tal. Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease. N Engl J Med 2007;356:775–89.
[53] Tashkin DP, Celli B, Senn S, Burkhart D, Kesten S, Menjoge S, et al. A 4-year trial of tiotropiumin chronic obstructive pulmonary disease.N Engl J Med 2008;359:1543–54.
[54] From the global strategy for the diagnosis, management and prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD). Available from:; 2011.
[55] Celli BR, Cote CG, Marin JM, Casanova C, Montes de Oca M, Mendez RA, et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med 2004;350:1005–12.
[56] Pedone C, Scarlata S, Scichilone N, Forastiere F, Bellia V, Antonelli Incalzi R. Alternative ways of expressing FEV1 and mortality in an elderly population with and without COPD. Eur Respir J 2013;41:800–5.
[57] Casanova C, de Torres JP, Aguirre-Jaíme A, Pinto-Plata V, Marin JM, Cordoba E, et al. The progression of chronic obstructive pulmonary disease is heterogeneous: the experience of the BODE cohort. Am J Respir Crit Care Med 2011;184:1015–21.
[58] Antonelli Incalzi R, Fuso L, De Rosa M, Forastiere F, Rapiti E, Nardecchia B, et al. Co-morbidity contributes to predict mortality of patients with chronic obstructive pulmonary disease. Eur Respir J 1997;10:2794–800.
[59] Incalzi RA, Fuso L, De Rosa M, Di Napoli A, Basso S, Pagliari G, et al. Electrocardiographic signs of chronic cor pulmonale: a negative prognostic finding in chronic obstructive pulmonary disease. Circulation 1999;99:1600–5.
[60] Antonelli-Incalzi R, Corsonello A, Pedone C, Trojano L, Acanfora D, Spada A, et al.
Drawing impairment predicts mortality in severe COPD. Chest 2006;130:1687–94.
[61] Royall DR. Double jeopardy. Chest 2006;130:1636–8.
[62] Fuso L, Incalzi RA, Pistelli R, Muzzolon R, Valente S, Pagliari G, et al. Predicting mortality of patients hospitalized for acutely exacerbated chronic obstructive pulmonary disease. Am J Med 1995;98:272–7.
[63] VogelmeierC, HedererB, GlaabT,Schmidt H,Rutten-van Mölken MP, Beeh KM, et al. Tiotropium versus salmeterol for the prevention of exacerbations of COPD. N Engl J Med 2011;364:1093–103.
[64] Board M, Allen SC. A simple drawing test to identify patients who are unlikely to be able to learn to use an inhaler. Int J Clin Pract 2006;60:510–3.
[65] Incalzi RA, Gemma A, Marra C, Capparella O, Fuso L, Carbonin P. Verbal memory impairment in COPD: its mechanisms and clinical relevance. Chest 1997;112:1506–13.
[66] Carlesimo GA, Caltagirone C, Gainotti G, The Group for the Standardization of the Mental Deterioration Battery. The Mental Deterioration Battery: normative data, diagnostic reliability and qualitative analyses of cognitive impairment. Eur Neurol 1996;36:378–84.
[67] Rey AL. Examen clinique en psychologie (Clinical tests in psychology). Paris: Presses Universitaires de France; 1964.
[68] Alexopoulos GS, Sirey JA, Raue PJ, Kanellopoulos D, Clark TE, Novitch RS. Outcomes of depressed patients undergoing inpatient pulmonary rehabilitation. Am J Geriatr Psychiatry 2006;14:466–75.
[69] Foglio K, Bianchi L, Bruletti G, Porta R, Vitacca M, Balbi B, et al. Seven-year time course of lung function, symptoms, health-related quality of life, and exercise tolerance in COPD patients undergoing pulmonary rehabilitation programs. Respir Med 2007;101:1961–70.
[70] Sewell L, Singh SJ, Williams JE, Collier R, Morgan MD. Can individualized rehabilitation improve functional independence in elderly patients with COPD? Chest 2005;128:1194–200.
[71] Carone M, Patessio A, Ambrosino N, Baiardi P, Balbi B, Balzano G, et al. Efficacy of pulmonary rehabilitation in chronic respiratory failure (CRF) due to chronic obstructive pulmonary disease (COPD): the Maugeri study. Respir Med 2007;101:2447–53.
[72] Di Meo F, Pedone C, Lubich S, Pizzoli C, Traballesi M, Incalzi RA. Age does not hamper the response to pulmonary rehabilitation of COPD patients. Age Ageing 2008;37:530–5.
[73] Corsonello A, Pedone C, Incalzi RA. Clinical and prognostic implications of cognitive dysfunction and depression in COPD. Current Respiratory Medicine Reviews 2007;3:107–15.
[74] Yohannes AM. Palliative care provision for patients with chronic obstructive pulmonary disease. Health Qual Life Outcomes 2007;5:17.
[75] Horton R, Rocker G, Dale A, Young J,Hernandez P, Sinuff T. Implementing a palliative care trial in advanced COPD: a feasibility assessment (the COPD IMPACT study). J Palliat Med 2013;16:67–73.
[76] Halpin DMG, Seamark DA, Seamark CJ. Palliative and end-of-life care for patients with respiratory disease. European respiratory society monograph 43, Respiratory diseases in the elderly; 2009. p. 327–53.
[77] Incalzi RA, Corsonello A, Pedone C, Battaglia S, Paglino G, Bellia V, Extrapulmonary Consequences of COPD in the Elderly Study Investigators. Chronic renal failure: a neglected comorbidity of COPD. Chest 2010;137:831–7.
[78] Paladini L, Hodder R, Cecchini I, Bellia V, Incalzi RA. The MRC dyspnoea scale by telephone interview to monitor health status in elderly COPD patients. Respir Med 2010;104:1027–34.
[79] Andrus MR, Holloway KP, Clark DB. Use of beta-blockers in patients with COPD. Ann Pharmacother 2004;38:142–5.
[80] Schlaich C, Minne HW, Bruckner T, Wagner G, Gebest HJ, Grunze M, et al. Reduced pulmonary function in patients with spinal osteoporotic fractures. Osteoporos Int 1998;8:261–7.
[81] Endeshaw Y. Clinical characteristics of obstructive sleep apnea in community-dwelling older adults. J Am Geriatr Soc 2006;54:1740–4.
[82] Collins PF, Elia M, Stratton RJ. Nutritional support and functional capacity in chronic obstructive pulmonary disease: a systematic review and meta-analysis. Respirology 2013.
[83] Fiatarone MA, O'Neill EF, Ryan ND, Clements KM, Solares GR, Nelson ME, et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med 1994;330:1769–75.
[84] Paladini L, Hodder R, Bellia V, Marchionni N, Di Bari M, Cecchini I, et al. Physician specialty as a source of heterogeneity in the care of patients with COPD. Chest 2011;140:1666–7.
[85] Bakke PS. Comorbidities in current COPD guidelines. Eur Respir Mon 2013;59:217–22.
[86] Miravitlles M, Murio C, Guerrero T, Gisbert R. Costs of chronic bronchitis and COPD:a 1-year follow-up study . Chest 2003;123:784–91.



Usted debe ingresar al sitio con su cuenta de usuario IntraMed para ver los comentarios de sus colegas o para expresar su opinión. Si ya tiene una cuenta IntraMed o desea registrase, ingrese aquí

Contenidos relacionados
Los editores le recomiendan continuar con las siguientes lecturas:
Términos y condiciones de uso | Todos los derechos reservados | Copyright 1997-2021