Assessment of Severity and Prognosis in Elderly Patients With COPD and Complex Chronic Comorbidities
Assessment of Severity and Prognosis in Elderly Patients With COPD and Complex Chronic Comorbidities
Cigarette smoking, the major risk factor for Chronic Obstructive Pulmonary Disease (COPD),
 causes systemic effects, such as systemic cellular and humoral inflammation, that could
 substantially contribute to the development of chronic diseases, other than COPD, mainly
 cardiovascular diseases and metabolic disorders. Such chronic comorbidities affect health
 outcomes in COPD, particularly in terms of disease severity and prognosis. The aim of the
 project is to investigate the prevalence of chronic comorbidities associated with COPD and
 their impact on prognosis in elderly patients.
The investigators will recruit 100 outpatients, heavy smokers (20 pack/years), older than 65
 years, diagnosed with COPD. COPD is defined by presence of fixed airflow limitation:
 post-bronchodilator forced expiratory volume at one second (FEV1)/forced vital capacity (FVC)
 less than 70% according to spirometry classification from Global Inititiative for Obstructive
 Lung Disease (GOLD) guidelines. Each patient will be characterized by medical history,
 physical examination, and smoking history. Each patient will perform pulmonary function test,
 including reversibility to inhaled bronchodilator (400 mcg albuterol), and 6-minute walk
 test. Arterial blood gases and routine blood test, including inflammatory biomarkers, will
 also examined. In addition, each patient will undergo chest X-ray, thorax CT scan,
 echocardiography, and carotid ultrasonography.

 At enrollment, all patients will be in stable condition (no changes in medication dosage or
 frequency, no COPD exacerbation or hospital admissions in the previous 4 weeks). Clinical and
 biological follow-up will be prospectively followed for 3 years.
Inclusion Criteria:

 -  Caucasians

 -  Age > 65 years

 -  Smoking history > 20 pack/years (current or former smokers)

 -  Diagnosis of COPD according to GOLD 2010

 -  Stable condition

 Exclusion Criteria:

 -  History of bronchial asthma

 -  Other chronic diseases such as interstitial lung disease, bronchiectasis,
 bronchiolitis obliterans organizing pneumonia (BOOP), pulmonary tuberculosis, cystic
 fibrosis

 -  Malignancies for which patient is being treated with radiotherapy or chemotherapy

 -  Acute events and/or hospitalization within 12 weeks prior to screening