Chronic obstructive pulmonary disease (COPD) is a progressive and irreversible lung disease that makes it difficult to breathe. Although treatments are available to help manage COPD symptoms, the damage to the lungs and airways is permanent. Over time, COPD flare-ups (periods of active or worsening symptoms) can happen more often and be more severe.

After receiving a COPD diagnosis, you’ll want to understand what it means for your future and how it might affect your life expectancy (how long you’re expected to live). Healthcare providers use several tests and staging systems to understand how your COPD is progressing. While these tools offer key information about your prognosis (outlook), life expectancy with COPD varies from person to person.

Continue reading to learn more about the factors that can affect your life expectancy with COPD.

How Do Doctors Assign COPD Stages?

Your healthcare team uses a staging system to understand the severity of your COPD, track your disease progression, and suggest the best treatments. The most common COPD staging system is the Global Initiative for Chronic Obstructive Lung Disease (GOLD) system. This system uses your symptoms, lung function, and history of flare-ups to assign the stages of COPD.

The most common COPD staging system is the Global Initiative for Chronic Obstructive Lung Disease (GOLD) system.

Spirometry is a key test to help determine the grade in the GOLD staging system. Spirometry tests — also known as pulmonary function tests — help measure how air flows through your lungs. The forced expiratory volume in 1 second (FEV1) is a measure of the amount of air you can exhale in one second.

The GOLD severity grade is based on the percentage of the predicted FEV1 for someone of your age, height, and race, as follows:

• GOLD 1 (mild COPD) — FEV1 is 80 percent or more of predicted FEV1
• GOLD 2 (moderate COPD) — FEV1 is 50 percent to 79 percent of predicted
• GOLD 3 (severe COPD ) — FEV1 is 30 percent to 49 percent of predicted
• GOLD 4 (very severe COPD) — FEV1 is less than 30 percent of predicted

To help choose the best treatment, your healthcare team will consider your FEV1 results as well as the following factors:

• The number of exacerbations (flare-ups) you’ve had in the past year
• How breathless you become during exercise and daily activities (also known as dyspnea)
• The severity of your symptoms of COPD

In addition to guiding your treatment options, your GOLD stage can also give your healthcare team important information about your prognosis.

Stages of COPD and Life Expectancy

COPD can affect your whole body. That’s why it makes sense that as COPD becomes more severe, it can also affect your life expectancy. However, few studies have directly examined how COPD severity impacts life expectancy.

In a 2020 study involving more than 500 people in Taiwan, researchers examined how the GOLD stage was linked to years of life expectancy lost in people with COPD. Researchers found that:

• People with mild COPD (GOLD 1) had no reduction in their life expectancy.
• People with moderate COPD (GOLD 2) lost an average of 6.2 years of their expected lifespan.
• In severe COPD (GOLD 3) and very severe COPD (GOLD 4), the researchers found that the average life expectancy was 9.4 years shorter than expected.

It’s important to remember that each individual’s prognosis and life expectancy depends on several factors. Although some studies can give you and your healthcare team an idea of what to expect, your outlook will be affected by your unique factors, including your comorbidities (other health conditions) and risk factors. Your healthcare team can help you understand how your GOLD stage may impact your life expectancy.

Other Factors That Affect Life Expectancy With COPD

Your GOLD stage is only one factor that helps explain how COPD may affect your life expectancy. Researchers have also looked at the effect of several other factors on life expectancy with COPD.

COPD Exacerbations

During a COPD exacerbation, you’ll experience worsening symptoms, such as:

• Difficulty breathing
• Thick mucus
• Wheezing
• Increased cough

Some people may need hospitalization during a COPD exacerbation to control their symptoms. Exacerbations typically happen more often in people with more severe COPD. More frequent exacerbations are strongly linked to worsening lung function, no matter how severe the exacerbations are.

In a 2012 study, researchers looked at more than 73,000 people hospitalized for the first time for COPD. They found that about half of the people in this study died within 3.6 years of their first hospitalization. Additionally, about 75 percent of people died within 7.7 years of being hospitalized for COPD for the first time. Additional research has found that the risk of death increases with more frequent exacerbations.

Lung Function

Lung function is often measured by FEV1. In general, COPD survival rates decrease as lung function decreases. Additionally, FEV1 is a key factor in determining your GOLD stage.

As FEV1 decreases, the risk of exacerbations goes up. More frequent exacerbations can lead to lung function decline and increased risk of death from COPD.

Lung Cancer

COPD is a significant risk factor for developing lung cancer. The risk of lung cancer is more than double in people with COPD compared to the general population. Compared to other types of cancer, lung cancer often has a lower survival rate. According to the American Lung Association, the five-year survival rate for lung cancer in the U.S. is about 30 percent. This means that about 3 in 10 people diagnosed with lung cancer are still alive five years after their diagnosis. However, survival rates are much higher when lung cancer is found and treated early.

COPD is a significant risk factor for developing lung cancer.

Improving Your Outlook With COPD

Although there isn’t a cure for COPD, medications and lifestyle changes may help improve your outlook.

COPD treatment options can help reduce how often you experience exacerbations, a key factor that can influence life expectancy with COPD. These treatments may include:

• Inhaled medications — Inhalers with bronchodilators or steroids can help open your airways and reduce airway inflammation.
• Corticosteroids — You may need a course of corticosteroids to help reduce inflammation during a flare-up.
• Antibiotics — These medications are used to treat and prevent bacterial infections in the lungs.
• Pulmonary rehabilitation — A pulmonary rehabilitation program includes exercises and education that help you manage COPD.
• Surgery — When other treatments don’t help, surgery may be an option to help improve COPD symptoms.

COPD treatments can help reduce your flare-ups and improve your outlook with the condition.

In addition to these treatment options, it’s also important to quit smoking if you smoke. Research shows that if you stop smoking, it may slow the progression of COPD.

Another way to protect your health with COPD is to prevent lung infections, which can lead to exacerbations. You can do this by:

• Staying up to date on your influenza, COVID-19, and pneumonia vaccines
• Washing your hands
• Avoiding crowded places
• Wearing a face mask when recommended

Work with your healthcare team to find the treatment plan that’s right for you. Once you develop a treatment plan together, it’s important to follow your plan as directed to help improve your symptoms and lower your risk of COPD flare-ups.

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