TY - JOUR
T1 - Clinical characteristics of subjects with symptoms of α1- antitrypsin deficiency older than 60 years
AU - Campos, Michael A.
AU - Alazemi, Saleh
AU - Zhang, Guoyan
AU - Salathe, Matthias
AU - Wanner, Adam
AU - Sandhaus, Robert A.
AU - Baier, Horst
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2009/3
Y1 - 2009/3
N2 - Background: The clinical characteristics of elderly subjects with α 1-antitrypsin deficiency (AATD)-associated COPD have not been described. Methods: The clinical, demographic, health-related quality of life (HRQoL) characteristics and 1-year exacerbation rates of 275 subjects with AATD and COPD receiving augmentation therapy aged > 59 years (mean [± SD] age, 66.3 ± 5.7 years) were compared to those of 354 subjects aged 50 to 59 years (mean age, 54.3 ± 2.8 years) and 293 subjects < 50 years (mean age, 43.9 ± 3.8 years). Results: Older subjects received diagnoses later in life (mean age at diagnosis, 55.0 ± 8.5 years) and had a longer diagnostic delay (mean age at diagnosis, 12.9 ± 14.3 years) than subjects in the other two age groups. Although the proportion of lifetime nonsmokers was higher in the older group, the majority (64%) had significant tobacco exposure but with a longer interval of tobacco abstinence. The mean FEV 1 values (n = 641) were similar between the three age groups, suggesting a slower disease progression in the oldest group. Subjects in the older group were less symptomatic, had less concomitant asthma, and had significantly better scores in most domains of two HRQoL instruments. During follow-up, older subjects had fewer acute exacerbations. Conclusions: Subjects with AATD-associated COPD who reach an older age exhibit a more indolent clinical course than younger affected individuals, possibly related in part to differences in tobacco exposure. This finding supports current guidelines that recommend screening of all patients with COPD for AATD, regardless of their age and prior smoking history.
AB - Background: The clinical characteristics of elderly subjects with α 1-antitrypsin deficiency (AATD)-associated COPD have not been described. Methods: The clinical, demographic, health-related quality of life (HRQoL) characteristics and 1-year exacerbation rates of 275 subjects with AATD and COPD receiving augmentation therapy aged > 59 years (mean [± SD] age, 66.3 ± 5.7 years) were compared to those of 354 subjects aged 50 to 59 years (mean age, 54.3 ± 2.8 years) and 293 subjects < 50 years (mean age, 43.9 ± 3.8 years). Results: Older subjects received diagnoses later in life (mean age at diagnosis, 55.0 ± 8.5 years) and had a longer diagnostic delay (mean age at diagnosis, 12.9 ± 14.3 years) than subjects in the other two age groups. Although the proportion of lifetime nonsmokers was higher in the older group, the majority (64%) had significant tobacco exposure but with a longer interval of tobacco abstinence. The mean FEV 1 values (n = 641) were similar between the three age groups, suggesting a slower disease progression in the oldest group. Subjects in the older group were less symptomatic, had less concomitant asthma, and had significantly better scores in most domains of two HRQoL instruments. During follow-up, older subjects had fewer acute exacerbations. Conclusions: Subjects with AATD-associated COPD who reach an older age exhibit a more indolent clinical course than younger affected individuals, possibly related in part to differences in tobacco exposure. This finding supports current guidelines that recommend screening of all patients with COPD for AATD, regardless of their age and prior smoking history.
KW - α -antitrypsin deficiency
KW - Age groups
KW - COPD
KW - Quality of life
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U2 - 10.1378/chest.08-1129
DO - 10.1378/chest.08-1129
M3 - Article
C2 - 19017884
AN - SCOPUS:62149113261
VL - 135
SP - 600
EP - 608
JO - Chest
JF - Chest
SN - 0012-3692
IS - 3
ER -