Managing older patients with coexistent asthma and chronic obstructive pulmonary disease: Diagnostic and therapeutic challenges

Drugs and Aging

Volumn 30, Issue 1, 2013, Pages 1-17

  McDonald, Vanessa M ^a,b,c   Higgins, Isabel ^b   Gibson, Peter G ^a,c,d,e  

^a UNIVERSITY OF NEWCASTLE   (Australia)

^b UNIVERSITY OF NEWCASTLE   (Australia)

^c JOHN HUNTER HOSPITAL   (Australia)

^d WOOLCOCK INSTITUTE OF MEDICAL RESEARCH   (Australia)

^e HUNTER MEDICAL RESEARCH INSTITUTE   (Australia)

Author keywords

[No Author keywords available]

Indexed keywords

C REACTIVE PROTEIN; CLARITHROMYCIN; CORTICOSTEROID; HYDROXYMETHYLGLUTARYL COENZYME A REDUCTASE INHIBITOR; INTERLEUKIN 1 RECEPTOR BLOCKING AGENT; INTERLEUKIN 1BETA; INTERLEUKIN 6; INTERLEUKIN 8; MACROLIDE; MACROPHAGE INFLAMMATORY PROTEIN 1ALPHA; MANNITOL; MONOCYTE CHEMOTACTIC PROTEIN 1; MUCOLYTIC AGENT; RANTES; TUMOR NECROSIS FACTOR ALPHA;

AGED; AGING; AIRWAY OBSTRUCTION; ANEMIA; ANXIETY DISORDER; ASTHMA; BRONCHIECTASIS; CARDIOVASCULAR DISEASE; CHRONIC BRONCHITIS; CHRONIC OBSTRUCTIVE LUNG DISEASE; CLINICAL FEATURE; CLINICAL PRACTICE; COMORBIDITY; CYSTIC FIBROSIS; DEPRESSION; DISEASE ASSOCIATION; DISEASE COURSE; DISEASE EXACERBATION; DISEASE MARKER; EOSINOPHIL COUNT; EOSINOPHILIA; FUNCTIONAL RESIDUAL CAPACITY; HUMAN; HYPERINFLATION; HYPERSALIVATION; INHALER; LONG TERM EXPOSURE; LUNG COMPLIANCE; LUNG FUNCTION; LUNG VOLUME; MALNUTRITION; MANAGEMENT; MUSCLE ATROPHY; NEUTROPHIL; NEUTROPHILIA; OBESITY; OSTEOPOROSIS; PRACTICE GUIDELINE; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL (TOPIC); RESIDUAL VOLUME; RESPIRATORY FAILURE; RESPIRATORY TRACT INFLAMMATION; REVIEW; RISK FACTOR; SLEEP DISORDER; SMOKING; SYSTEMATIC REVIEW (TOPIC);

AGED; AGING; ASTHMA; HUMANS; PULMONARY DISEASE, CHRONIC OBSTRUCTIVE;

EID: 84876231448     PISSN: 1170229X     EISSN: 11791969     Source Type: Journal    
DOI: 10.1007/s40266-012-0042-z     Document Type: Review

References (208)

1. Gibson PG, McDonald VM, Marks GB. Asthma in the older adult. Lancet. 2010;374(9743):803-13.
2. McDonald VM, Simpson JL, Higgins I, et al. Multidimensional assessment of older people with asthma & COPD: clinical management and health status. Age Ageing. 2011;40(1):42-9.
3. Cosio BG, Agusti A. Comorbidity: a distinctive feature of elderly respiratory patients. Eur Respir Mon. 2009;43:205-16.
4. Hanania NA, King MJ, Braman SS, et al. Asthma in the elderly: current understanding and future research needs - a report of a National Institute on Aging (NIA) workshop. J Allergy Clin Immunol. 2011;128(3 Suppl):S4-24.
5. McDonald VM, Gibson PG. Asthma mortality and management in older Australians: time for a new approach? Australas J Ageing. 2008;27:215.
6. Navaratnam P, Jayawant SS, Pedersen CA, et al. Asthma pharmacotherapy prescribing in the ambulatory population of the United States: evidence of nonadherence to national guidelines and implications for elderly people. J Am Geriatr Soc. 2008;56(7):1312-7.
7. Hill K, Goldstein RS, Guyatt GH, et al. Prevalence and underdiagnosis of chronic obstructive pulmonary disease among patients at risk in primary care. CMAJ. 2010;182(7):673-8.
8. Bednarek M, Maciejewski J, Wozniak M, et al. Prevalence, severity and underdiagnosis of COPD in the primary care setting. Thorax. 2008;63(5):402-7.
9. Buist SA, McBurnie MA, Vollmer WM, et al. International variation in the prevalence of COPD (The BOLD Study): a population-based prevalence study. Lancet. 2007;370:741-50.
10. Antonelli Incalzi R, Pedone C, Pahor M. Multidimensional assessment and treatment of the elderly with COPD. Eur Respir Mon. 2009(43):35-55.
11. Beasley R, Weatherall M, Travers J, et al. Time to define the disorders of the syndrome of COPD. Lancet. 2009;29:670-2.
12. Guerra S. Asthma and chronic obstructive pulmonary disease. Curr Opin Allergy Clin Immunol. 2009;9:409-16.
13. Fabbri LM, Luppi F, Beghé B, et al. Complex chronic comorbidities of COPD. Eur Respir J. 2008;31:204-12.
14. Marks GB, Poulos LM, Jenkins CR, et al. Asthma in older adults: a holistic, person centred and problem oriented approach. Med J Aust. 2009;191(4):197-9.
15. United Nations. Report of the Second World Assembly on Ageing. Madrid, Spain: United Nations; 2002.
16. Productivity Commission. Economic implications of an ageing Australia, research report. Canberra: Commonwealth of Australia; 2005.
17. Asher MI, Montefort S, Björkstén B, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC phases one and three repeat multicountry cross sectional surveys. Lancet. 2006;368(9537):733-43.
18. Bellia V, Scichilone N, Battaglia S. Asthma in the elderly. Eur Respir Mon. 2009;43:56-76.
19. Sharma G, Goodwin J. Effect of aging on respiratory system physiology and immunology. Clin Interv Aging. 2006;1(3):253-60.
20. Berend N. Normal ageing of the lung: implications for diagnosis and monitoring of asthma in older people. Med J Aust. 2005;183(1 Suppl):S28-9.
21. De Martinis M, Franceschi C, Monti D, et al. Inflamm-ageing and lifelong antigenic load as major determinants of ageing rate and longevity. FEBS Lett. 2005;579(10):2035-9.
22. Meyer KC, Rosenthal NS, Sorergel P, et al. Neutrophils and low grade inflammation in the seemingly normal aging human lung. Mech Aging Dev. 1998;104(2):169-81.
23. Thompson AB, Scholer SG, Daughton DM, et al. Altered epithelial lining fluid parameters in old normal individuals. J Gerontol. 1992;47(5):M171-6.
24. Sharma G, Hanania NA, Shim YM. The aging immune system and its relationship to the development of chronic obstructive pulmonary disease. Proc Am Thorac Soc. 2009;6(7):573-80.
25. Boyd CM, Darer J, Boult C, et al. Clinical practice guidelines and quality of care for older patients with multiple co-morbid diseases. J Am Med Assoc. 2005;294(6):716-24.
26. Wilper AP, Woolhandler S, Lasser KE, et al. A national study of chronic disease prevalence and access to care in uninsured U.S. adults. Ann Intern Med. 2008;149(3):170-6.
27. Boulet LP, Turcotte H, Turcot O, et al. Airway inflammation in asthma with incomplete reversibility of airflow obstruction. Respir Med. 2003;97:739-44.
28. Mannino DM, Hole D, Gillis C, et al. The natural history of chronic obstructive pulmonary disease. Eur Respir J. 2006;27(3):627-43.
29. Fabbri L, Ferrari R. Chronic disease in the elderly: back to the future of internal medicine. Breathe. 2006;3:41-9.
30. Luppi F, Franco F, Beghé B, et al. Treatment of chronic obstructive pulmonary disease and its comorbidities. Proc Am Thorac Soc. 2008;5:848-56.
31. Agustí A. Systemic effects of chronic obstructive pulmonary disease: what we know and what we don't know (but should). Proc Am Thorac Soc. 2007;4(7):522-5.
32. Quinet P, Young CA, Héritier F. The use of dry powder inhaler devices by elderly patients suffering from chronic obstructive pulmonary disease. Ann Phys Rehabil Med. 2010;53(2):69-76.
33. Janssens W, Vandenbrande P, Hardeman E, et al. Inspiratory flow rates at different levels of resistance in elderly COPD patients. Eur Respir J. 2008;31(1):78-83.
34. Seemungal TA, Donaldson GC, Paul EA, et al. Effect of exacerbation on quality of life in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1998;157(5 Pt 1):1418-22.
35. Wedzicha JA, Calverley PM, Seemungal TA, et al. The prevention of chronic obstructive pulmonary disease exacerbations by salmeterol/fluticasone propionate or tiotropium bromide. Am J Respir Crit Care Med. 2008;177(1):19-26.
36. Banning M. Older people and adherence with medication: a review of the literature. Int J Nurs Stud. 2008;45(10):1550-61.
37. Goeman DP, Douglass JA. Optimal management of asthma in elderly patients: strategies to improve adherence to recommended interventions. Drugs Aging. 2007;24(5):381-94.
38. Vozoris NT, Stanbrook MB. Smoking prevalence, behaviours, and cessation among individuals with COPD or asthma. Respir Med. 2011;105(3):477-84.
39. Gibson PG, Talbot PI, Toneguzzi RC. Self-management, autonomy, and quality of life in asthma. Chest. 1995;107(4):1003-8.
40. Little P, Everitt H, Williamson I. Preferences of patients for patient centered approach to consultation in primary care: observational study. BMJ. 2001;322(7284):468-72.
41. Dodd JW, Getov SV, Jones PW. Cognitive function in COPD. Eur Respir J. 2010;35(4):913-22.
42. GINA. Global strategy for asthma management and prevention: NHLBI/WHO workshop report. Bethesda (MD): Global Initiative for Asthma (GINA), National Heart, Lung and Blood Institute (NHLBI); 2006.
43. Rabe KF, Hurd S, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of COPD 2006 Update. Am J Respir Crit Care Med. 2007;176:532-55.
44. Gibson PG, Simpson JS. The overlap syndrome of asthma and COPD: what are its features and how important is it? Thorax. 2009;64:728-35.
45. Snider GL. Distinguishing among asthma, chronic bronchitis, and emphysema. Chest. 1985;87(1 Suppl):35S-9S.
46. American Thoracic Society. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1995;152:s77-121.
47. Soriano JB, Davis KJ, Coleman B, et al. The proportional Venn diagram of obstructive lung disease: two approximations from the United States and the United Kingdom. Chest. 2003;124:474-81.
48. Marsh SE, Travers J, Weatherall M, et al. Proportional classifications of COPD phenotypes. Thorax. 2008;63:761-7.
49. Weatherall M, Travers J, Shirtcliffe PM, et al. Distinct clinical phenotypes of airways disease defined by cluster analysis. Eur Respir J. 2009;34(4):812-8.
50. Vonk JM, Jongepier H, Panhuysen CIM, et al. Risk factors associated with the presence of irreversible airflow limitation and reduced transfer coefficient in patients with asthma after 26 years of follow up. Thorax. 2003;58:322-7.
51. Calverley PM, Burge PS, Spencer S, et al. Bronchodilator reversibility testing in chronic obstructive pulmonary disease. Thorax. 2003;58(8):659-64.
52. Reid DW, Soltani A, Johns DP, et al. Bronchodilator reversibility in Australian adults with chronic obstructive pulmonary disease. Intern Med J. 2003;33(12):572-7.
53. Simpson JL, Scott R, Boyle M, et al. Inflammatory subtypes in asthma: assessment and identification using induced sputum. Respirology. 2006;11:54-61.
54. Gorska K, Krenke R, Korczynski P, et al. Eosinophilic airway inflammation in chronic obstructive pulmonary disease and asthma. J Physiol Pharmacol. 2008;59(Suppl 6):261-70.
55. Siva R, Green RH, Brightling CE, et al. Eosinophilic airway inflammation and exacerbations of COPD: a randomised controlled trial. Eur Respir J. 2007;29(5):906-13.
56. Simpson JL, Powell H, Boyle MJ, et al. Clarithromycin targets neutrophilic airway inflammation in refractory asthma. Am J Respir Crit Care Med. 2008;177(2):148-55.
57. Hargreave FE, Nair P. The definition and diagnosis of asthma. Clin Exp Allergy. 2009;39:1652-8.
58. D'silva L, Cook RJ, Allen CJ, et al. Changing pattern of sputum cell counts during successive exacerbations of airway disease. Respir Med. 2007;101:2217-20.
59. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease. Bethesda (MD): Global Initiative for Chronic Obstructive Lung Disease; 2011.
60. McKenzie DK, Abramson M, Crockett AJ, et al. The COPD-X Plan: Australian and New Zealand guidelines for the management of chronic obstructive pulmonary disease 2009. Brisbane: Australian Lung Foundation; 2009. http://www.copdx.org. au/guidelines/index.asp. Accessed 3 Feb 2009.
61. Burge PS, Calverley PM, Jones PW, et al. Randomised, double blind, placebo controlled study of fluticasone propionate in patients with moderate to severe chronic obstructive pulmonary disease: the ISOLDE trial. BMJ. 2000;320(7245):1297-303.
62. Sin DD, Wu L, Anderson JA, et al. Inhaled corticosteroids and mortality in chronic obstructive pulmonary disease. Thorax. 2005;60(12):992-7.
63. Gibson PG, Powell H, Coughlin J, et al. Self-management education and regular practitioner review for adults with asthma. Cochrane Database of Systematic Reviews. 2003;(3):CD001117.
64. Effing TW, Monninkhof EM, van der Valk PDLPM, et al. Self-management education for patients with chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2007;(4):CD002990.
65. Willemse BW, Postma DS, Timens W, et al. The impact of smoking cessation on respiratory symptoms, lung function, airway hyperresponsiveness and inflammation. Eur Respir J. 2004;23(3):464-76.
66. Franceschi C, Bonafè M. Centenarians as a model for healthy aging. Biochem Soc Trans. 2003;31(2):457-61.
67. Fabbri LM, Rabe KF. From COPD to chronic systemic inflammatory syndrome? Lancet. 2007;1(370):797-9.
68. Agustí AG, Noguera A, Sauleda J, et al. Systemic effects of chronic obstructive pulmonary disease. Eur Respir J. 2003;21:347-60.
69. Gan WQ, Man SF, Senthilselvan A, et al. Association between chronic obstructive pulmonary disease and systemic inflammation: a systematic review and a meta-analysis. Thorax. 2004;59(7):574-80.
70. Yokoyama A, Kohno N, Fujino S, et al. Circulating interleukin-6 levels in patients with bronchial asthma. Am J Respir Crit Care Med. 1995;151(5):1354-8.
71. Takemura M, Matsumoto H, Niimi A, et al. High sensitivity C-reactive protein in asthma. Eur Respir J. 2006;27(5):908-12.
72. Higashimoto Y, Yamagata Y, Taya S, et al. Systemic inflammation in chronic obstructive pulmonary disease and asthma: similarities and differences. Respirology. 2008;13:128-33.
73. Pauwels R, Calverley P, Buist AS, et al. COPD exacerbations: the importance of a standard definition. Resp Med. 2004;98:99-107.
74. Hurst JR, Wedzicha JA. The biology of a chronic obstructive pulmonary disease exacerbation. Clin Chest Med. 2007;28(3):525-36.
75. Barnes PJ, Celli BR. Systemic manifestations and comorbidities of COPD. Eur Respir J. 2009;33(5):1165-85.
76. Smith DJ, Yerkovich ST, Towers MA, et al. Reduced soluble receptor for advanced glycation end-products in COPD. Eur Respir J. 2011;37(3):516-22.
77. Lopez-Campos J, Arellano E, Calero C, et al. Determination of inflammatory biomarkers in patients with COPD: a comparison of different assays. BMC Med Res Methodol. 2012;12(1):40.
78. Bozinovski S, Uddin M, Vlahos R, et al. Serum amyloid A opposes lipoxin A to mediate glucocorticoid refractory lung inflammation in chronic obstructive pulmonary disease. Proc Natl Acad Sci USA. 2012;109(3):935-40.
79. Celli BR, Locantore N, Yates J, et al. Inflammatory biomarkers improve clinical prediction of mortality in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2012;23:23.
80. Lomas DA, Silverman EK, Edwards LD, et al. Evaluation of serum CC-16 as a biomarker for COPD in the ECLIPSE cohort. Thorax. 2008;63(12):1058-63.
81. Verrills NM, Irwin JA, He XY, et al. Identification of novel diagnostic biomarkers for asthma and chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2011;183(12):1633-43.
82. American Healthways, Johns Hopkins. Standard outcome metrics and evaluation outcome methodology for disease management programmes. Second Annual Disease Management Outcomes Summit; 2002 Nov 7-10; Palm Desert, CA. Franklin, TN: American Healthways; 2002.
83. Vitry AI, Zhang Y. Quality of Australian clinical guidelines and relevance to the care of older people with multiple comorbid conditions. Med J Aust. 2008;189(7):360-5.
84. Craig BM, Kraus CK, Chewning BA, et al. Quality of care for older adults with chronic obstructive pulmonary disease and asthma based on comparisons to practice guidelines and smoking status. BMC Health Serv Res. 2008;8:1-9.
85. Costantino G, Rusconi AM, Duca PG, et al. Eligibility criteria in heart failure randomized controlled trials: a gap between evidence and clinical practice. Intern Emerg Med. 2008;4(2):117-22.
86. Travers J, Marsh S, Williams M, et al. External validity of randomised controlled trials in asthma: to whom do the results of the trials apply? Thorax. 2007;62(3):219-23.
87. Travers J, Marsh S, Caldwell B, et al. External validity of randomized controlled trials in COPD. Respir Med. 2007;101(6):1313-20.
88. Ware JH, Hamel MB. Pragmatic trials - guides to better patient care? N Engl J Med. 2011;364(18):1685-7.
89. Decramer M, Celli B, Kesten S, et al. Effect of tiotropium on outcomes in patients with moderate chronic obstructive pulmonary disease (UPLIFT): a prespecified subgroup analysis of a randomised controlled trial. Lancet. 2009;374(9696):1171-8.
90. Gibson PG. Using fractional exhaled nitric oxide to guide asthma therapy: design and methodological issues for ASthma TReatment ALgorithm studies. Clin Exp Allergy. 2009;39(4):478-90.
91. Powell H, Murphy VE, Taylor DR, et al. Management of asthma in pregnancy guided by measurement of fraction of exhaled nitric oxide: a double-blind, randomised controlled trial. Lancet. 2011;378(9795):983-90.
92. Hunter DJ, Fairfield G. Disease management. Br Med J. 1997;315(7099):50-3.
93. Hunter DJ. Disease management: has it a future? It has a compelling logic, but needs to be tested in practice. Br Med J. 2000;320(7234):530.
94. Solomon D, Brown SA, Brummel-Smith K, et al. Best paper of the 1980 s: National Institutes of Health Consensus Development Conference Statement: geriatric assessment methods for clinical decision-making. 1988. J Am Geriatr Soc. 2003;51(10):1490-4.
95. Vliek S, Melis RJ, Faes M, et al. Single versus multicomponent intervention in frail elderly: simplicity or complexity as precondition for success? J Nutr Health Aging. 2008;12(5):319-22.
96. Stuck AE, Siu AL, Wieland GD, et al. Comprehensive geriatric assessment: a meta-analysis of controlled trials. Lancet. 1993;342:1032-6.
97. McDonald VM, Higgins I, Wood LG, et al. Multidimensional assessment and individualised management of obstructive airway diseases (OAD) in older adults. Respirology. 2011;16:13.
98. Koff PB, Jones RH, Cashman JM, et al. Proactive integrated care improves quality of life in patients with COPD. Eur Respir J. 2009;33(5):1031-8.
99. Rice KL, Dewan N, Bloomfield HE, et al. Disease management program for chronic obstructive pulmonary disease: a randomized controlled trial. Am J Respir Crit Care Med. 2010;182(7):890-6.
100. Reilly JJ. COPD and declining FEV1 - time to divide and conquer? N Engl J Med. 2008;359:1616-8.
101. McDonald VM, Higgins I, Simpson JL, et al. The importance of clinical management problems in older people with COPD and asthma: do patients and physicians agree? Prim Care Respir J. 2011;20(4):389-95.
102. National Ageing Research Institute. What is person-centred health care? A literature review. Melbourne: Ageing and Complex Care, Continuing Care, Integrated Care, Wellbeing, Integrated Care and Ageing, Department of Health; 2006.
103. Bauman AE, Fardy HJ, Harris PG. Getting it right: why bother with patient-centered care? Med J Aust. 2003;179(5):253-6.
104. Wilson SR, Strub P, Buist AS, et al. Shared treatment decision making improves adherence and outcomes in poorly controlled asthma. Am J Respir Crit Care Med. 2010;181(6):566-77.
105. Nair P, Pizzichini MM, Kjarsgaard M, et al. Mepolizumab for prednisone-dependent asthma with sputum eosinophilia. N Engl J Med. 2009;360(10):985-93.
106. Green RH, Brightling CE, McKenna S, et al. Asthma exacerbations and sputum eosinophil counts: a randomised controlled trial. Lancet. 2002;30:1715-21.
107. Jayaram L, Pizzichini MM, Cook RJ, et al. Determining asthma treatment by monitoring sputum cell counts: effect on exacerbations. Eur Respir J. 2006;27:483-94.
108. Petsky HL, Kynaston JA, Turner C, et al. Tailored interventions based on sputum eosinophils versus clinical symptoms for asthma in children and adults. Cochrane Database of Systematic Reviews. 2007; (2): CD005603.
109. Albert RK, Connett J, Bailey WC, et al. Azithromycin for prevention of exacerbations of COPD. N Engl J Med. 2011;365(8):689-98.
110. Seemungal TA, Wilkinson TM, Hurst JR, et al. Long-term erythromycin therapy is associated with decreased chronic obstructive pulmonary disease exacerbations. Am J Respir Crit Care Med. 2008;178(11):1139-47.
111. He ZY, Ou LM, Zhang JQ, et al. Effect of 6 months of erythromycin treatment on inflammatory cells in induced sputum and exacerbations in chronic obstructive pulmonary disease. Respiration. 2010;80(6):445-52.
112. Figueiredo Bde C, Ibiapina Cda C. The role of macrolides in noncystic fibrosis bronchiectasis. Pulm Med. 2011; 2011: 751982. doi: 10.1155/2011/751982.
113. Saiman L, Marshall BC, Mayer-Hamblett N, et al. Azithromycin in patients with cystic fibrosis chronically infected with Pseudomonas aeruginosa: a randomized controlled trial. JAMA. 2003;290(13):1749-56.
114. Tateda K, Standiford TJ, Pechere JC, et al. Regulatory effects of macrolides on bacterial virulence: potential role as quorum-sensing inhibitors. Curr Pharm Des. 2004;10:3055-65.
115. López-Boado YS, Rubin BK. Macrolides as immunomodulatory medications for the therapy of chronic lung diseases. Curr Opin Pharmacol. 2008;8:286-91.
116. Mora S, Ridker PM. Justification for the Use of Statins in Primary Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER) - can C-reactive protein be used to target statin therapy in primary prevention? Am J Cardiol. 2006;97(2A):33A-41A.
117. Ridker PM, Cannon CP, Morrow D, et al. C-reactive protein levels and outcomes after statin therapy. N Engl J Med. 2005;352(1):20-8.
118. Lee T-M, Lin M-S, Chang N-C. Usefulness of C-reactive protein and interleukin-6 as predictors of outcomes in patients with chronic obstructive pulmonary disease receiving pravastatin. Am J Cardiol. 2008;101(4):530-5.
119. Suissa S. Co-morbidity in COPD: the effects of cardiovascular drug therapies. Respiration. 2010;80(1):3-7.
120. Lee T-M, Chen C-C, Shen H-N, et al. Effects of pravastatin on functional capacity in patients with chronic obstructive pulmonary disease and pulmonary hypertension. Clin Sci. 2009;116(6):497-505.
121. Blamoun AI, Batty GN, DeBari VA, et al. Statins may reduce episodes of exacerbation and the requirement for intubation in patients with COPD: evidence from a retrospective cohort study. Int J Clin Pract. 2008;62(9):1373-8.
122. Keddissi JI, Younis WG, Chbeir EA, et al. The use of statins and lung function in current and former smokers. Chest. 2007;132(6):1764-71.
123. Mancini GB, Etminan M, Zhang B, et al. Reduction of morbidity and mortality by statins, angiotensin-converting enzyme inhibitors, and angiotensin receptor blockers in patients with chronic obstructive pulmonary disease. J Am Coll Cardiol. 2006;47(12):2554-60.
124. Frost FJ, Petersen H, Tollestrup K, et al. Influenza and COPD mortality protection as pleiotropic, dose-dependent effects of statins. Chest. 2007;131(4):1006-12.
125. Ishida W, Kajiwara T, Taneichi H, et al. Decrease in mortality rate of chronic obstructive pulmonary disease (COPD) with statin use: a population-based analysis in Japan. Tohoku J Exp Med. 2007;212(3):265-73.
126. van Gestel YRBM, Hoeks SE, Sin DD, et al. Effect of statin therapy on mortality in patients with peripheral arterial disease and comparison of those with versus without associated chronic obstructive pulmonary disease. Am J Cardiol. 2008;102(2):192-6.
127. Ulrik CS, von Linstow ML, Nepper-Christensen S, Porsbjerg C, Backer V. Chronic mucus hypersecretion: a marker of asthma in young adults. Respir Med. 2005;99:1576-82.
128. Pauwels RA, Buist AS, Calverley PM, Jenkins CR, Hurd SS, GOLD Scientific Committee. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) workshop summary. Am J Respir Crit Care Med. 2001;163:1256-76.
129. Rogers DF. Mucoactive agents for airway mucus hypersecretory diseases. Respir Care. 2007;52:1176-93.
130. Henke MO, Shah SA, Rubin BK. The role of airway secretions in COPD - clinical applications. COPD. 2005;2:377-90.
131. Elkins MR, Robinson M, Rose BR, et al. A controlled trial of long-term inhaled hypertonic saline in patients with cystic fibrosis. N Engl J Med. 2006;354:229-40.
132. Wark P, McDonald VM. Nebulised hypertonic saline for cystic fibrosis. Cochrane Database of Systematic Reviews. 2009;(2): CD001506.
133. Pavia D, Thomson ML, Clarke SW. Enhanced clearance of secretions from the human lung after the administration of hypertonic saline aerosol. Am J Respir Crit Care Med. 1978;117:199-203.
134. Clarke SW, Lopez-Vidriero MT, Pavia D, et al. The effect of sodium 2-mercapto-ethane sulphonate and hypertonic saline aerosols on bronchial clearance in chronic bronchitis. Br J Clin Pharmacol. 1979;7:39-44.
135. Daviskas E, Anderson SD, Young IH. Inhaled mannitol changes the sputum properties in asthmatics with mucus hypersecretion. Respirology. 2007;12(5):683-91.
136. Wills P, Greenstone M. Inhaled hyperosmolar agents for bronchiectasis. Cochrane Database of Systematic Reviews. 2006;(2): CD002996.
137. Sabit R, Bolton CE, Edwards PH, et al. Arterial stiffness and osteoporosis in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2007;175(12):1259-65.
138. Sin DD, Wu L, Man SF. The relationship between reduced lung function and cardiovascular mortality: a population-based study and a systematic review of the literature. Chest. 2005;127(6):1952-9.
139. Shamsham F, Mitchell J. Essentials of the diagnosis of heart failure. Fam Physician. 2000;61:1319-28.
140. Roth SM, Metter EJ, Ling S, et al. Inflammatory factors in age-related muscle wasting. Curr Opin Rheumatol. 2006;18:625-30.
141. Schols AM, Soeters PB, Dingemans AM, et al. Prevalence and characteristics of nutritional depletion in patients with stable COPD eligible for pulmonary rehabilitation. Am Rev Respir Dis. 1993;147:1151-6.
142. Mostert R, Goris A, Weling-Scheepers C, et al. Tissue depletion and health related quality of life in patients with chronic obstructive pulmonary disease. Respir Med. 2000;94(4):859-67.
143. Flegal KM, Carroll MD, Ogden CL, et al. Prevalence and trends in obesity among US adults, 1999-2000. JAMA. 2002;288(14):1723-7.
144. Oreopoulos A, Kalantar-Zadeh K, Sharma AM, et al. The obesity paradox in the elderly: potential mechanisms and clinical implications. Clin Geriatr Med. 2009;24(4):643-59.
145. Losonczy KG, Harris TB, Cornoni-Huntley J, et al. Does weight loss from middle age to old age explain the inverse weight mortality relation in old age? Am J Epidemiol. 1995;141(4):312-21.
146. Grabowski DC, Ellis JE. High body mass index does not predict mortality in older people: analysis of the Longitudinal Study of Aging. J Am Geriatr Soc. 2001;49(7):968-79.
147. Villareal DT, Apovian CM, Kushner RF, et al. Obesity in older adults: technical review and position statement of the American Society for Nutrition and NAASO, The Obesity Society. Am J Clin Nutr. 2005;82(5):923-34.
148. Chailleux E, Laaban JP, Veale D. Prognostic value of nutritional depletion in patients with COPD treated by long-term oxygen therapy: data from the ANTADIR observatory. Chest. 2003;123(5):1460-6.
149. Landbo C, Prescott E, Lange PT, et al. Prognostic value of nutritional status in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1999;160:1856-61.
150. Celli BR, Cote CG, Marin JM, et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med. 2004;350(10):1005-12.
151. Schols AM, Slangen J, Volovics L, et al. Weight loss is a reversible factor in the prognosis of chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1998;157:1791-7.
152. Haslam DW, James WP. Obesity. Lancet. 2005;366(9492):1197-209.
153. Flicker L, McCaul KA, Hankey GJ, et al. Body mass index and survival in men and women aged 70 to 75. J Am Geriatr Soc. 2010;58(2):234-41.
154. Franssen FME, O'Donnell DE, Goossens GH, et al. Obesity and the lung: 5. Obesity and COPD. Thorax. 2008;63:1110-7.
155. Steuten LM, Creutzberg EC, Vrijhoef HJ, et al. COPD as a multicomponent disease: inventory of dyspnoea, underweight, obesity and fat free mass depletion in primary care. Prim Care Respir J. 2006;15:84-91.
156. Eisner MD, Blanc PD, Sidney S, et al. Body composition and functional limitation in COPD. Respir Res. 2007;8:7.
157. Aronson D, Bartha P, Zinder O, et al. Obesity is the major determinant of elevated C-reactive protein in subjects with the metabolic syndrome. Int J Obes Relat Metab Disord. 2004;28:674-9.
158. Florez H, Castillo-Florez S, Mendez A, et al. C-reactive protein is elevated in obese patients with the metabolic syndrome. Diabetes Res Clin Pract. 2006;71:92-100.
159. Vandenbergh E, Van de Woestijne KP, Gyselen A. Weight changes in the terminal stages of chronic obstructive pulmonary disease. Relation to respiratory function and prognosis. Am Rev Respir Dis. 1967;95:556-66.
160. Celli BR, Thomas NE, Anderson JA, et al. Effect of pharmacotherapy on rate of decline of lung function in chronic obstructive pulmonary disease: results from the TORCH study. Am J Respir Crit Care Med. 2008;178:322-3.
161. Peters-Golden M, Swern A, Bird SS, et al. Influence of body mass index on the response to asthma controller agents. Eur Respir J. 2006;27(3):495-503.
162. Wood LG, Gibson PG. Dietary factors lead to innate immune activation in asthma. Pharmacol Ther. 2009;123(1):37-53.
163. Harrington JJ, Lee-Chiong T Jr. Sleep and older patients. Clin Chest Med. 2007;28(4):673-84.
164. Foley DJ, Monjan AA, Brown SL, et al. Sleep complaints among elderly persons: an epidemiologic study of three communities. Sleep. 1995;18(6):425-32.
165. Boulet LP. Influence of comorbid conditions on asthma. Eur Respir J. 2009;33(4):897-906.
166. Zamarrón C, García Paz V, Morete E, et al. Association of chronic obstructive pulmonary disease and obstructive sleep apnea consequences. Int J Chron Obstruct Pulmon Dis. 2008;3(4):671-82.
167. Jorgensen NR, Schwarz P, Holme I, et al. The prevalence of osteoporosis in patients with chronic obstructive pulmonary disease - a cross sectional study. Respir Med. 2007;101:177-85.
168. Israel E, Banerjee TR, Fitzmaurice GM, et al. Effects of inhaled glucocorticoids on bone density in premenopausal women. N Engl J Med. 2001;345(13):941-7.
169. Ip M, Lam K, Yam L, et al. Decreased bone mineral density in premenopausal asthma patients receiving long-term inhaled steroids. Chest. 1994;105(6):1722-7.
170. Cote C, Zilberberg MD, Mody SH, et al. Haemoglobin level and its clinical impact in a cohort of patients with COPD. Eur Respir J. 2007;29(5):923-9.
171. Kvaal K, Macijauskiene J, Engedal K, et al. High prevalence of anxiety symptoms in hospitalized geriatric patients. Int J Geriatr Psychiatry. 2001;16(7):690-3.
172. Cafarella PA, Effing TW, Usmani ZA, et al. Treatments for anxiety and depression in patients with chronic obstructive pulmonary disease: a literature review. Respirology. 2012;17(4):627-38.
173. Yohannes AM, Baldwin RC, Connolly MJ. Prevalence of sub-threshold depression in elderly patients with chronic obstructive pulmonary disease. Int J Geriatr Psychiatry. 2003;18(5):412-6.
174. Kim HF, Kunik ME, Molinari VA, et al. Functional impairment in COPD patients: the impact of anxiety and depression. Psychosomatics. 2000;41(6):465-71.
175. Kunik ME, Roundy K, Veazey C, et al. Surprisingly high prevalence of anxiety and depression in chronic breathing disorders. Chest. 2005;127(4):1205-11.
176. DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med. 2000;160(14):2101-7.
177. Yohannes AM, Baldwin RC, Connolly MJ. Predictors of 1-year mortality in patients discharged from hospital following acute exacerbation of chronic obstructive pulmonary disease. Age Ageing. 2005;34(5):491-6.
178. Maurer J, Rebbapragada V, Borson S, et al. Anxiety and depression in COPD: current understanding, unanswered questions, and research needs. Chest. 2008;134(4 Suppl):43S-56S.
179. Rennard SI, Farmer SG. Exacerbations and progression of disease in asthma and chronic obstructive pulmonary disease. Proc Am Thorac Soc. 2004;1(2):88-92.
180. Hurst JR, Donaldson GC, Quint JK, et al. Temporal clustering of exacerbations in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2009;179(5):369-74.
181. Bai TR, Vonk JM, Postma DS, et al. Severe exacerbations predict excess lung function decline in asthma. Eur Respir J. 2007;30(3):452-6.
182. Clarke SW. Management of mucus hypersecretion. Eur Resp J. 1987;136-44:153.
183. Vestbo J, Prescott E, Lange P. Association of chronic mucus hypersecretion with FEV1 decline and chronic obstructive pulmonary disease morbidity. Copenhagen City Heart Study Group. Am J Respir Crit Care Med. 1996;153:1530-5.
184. Rogers DF. Airway mucus hypersecretion in asthma: an undervalued pathology? Curr Opin Pharmacol. 2004;4(3):241-50.
185. Roche N. Activity limitation: a major consequence of dyspnoea in COPD. Eur Respir Rev. 2009;18(112):54-7.
186. Pitta F, Troosters T, Spruit MA, et al. Characteristics of physical activities in daily life in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2005;171(9):972-7.
187. Schönhofer B, Ardes P, Geibel M, et al. Evaluation of a movement detector to measure daily activity in patients with chronic lung disease. Eur Respir J. 1997;10(12):2814-9.
188. Jones PW. Activity limitation and quality of life in COPD. COPD. 2007;4(3):273-8.
189. Garcia-Aymerich J, Lange P, Benet M, et al. Regular physical activity modifies smoking-related lung function decline and reduces risk of chronic obstructive pulmonary disease: a population-based cohort study. Am J Respir Crit Care Med. 2007;175(5):458-63.
190. Strine TW, Balluz LS, Ford ES. The associations between smoking, physical inactivity, obesity, and asthma severity in the general US population. J Asthma. 2008;44(8):651-8.
191. Sherriff A, Maitra A, Ness AR, et al. Association of duration of television viewing in early childhood with the subsequent development of asthma. Thorax. 2009;64(4):321-5.
192. Rasmussen F, Lambrechtsen J, Siersted HC, et al. Low physical fitness in childhood is associated with the development of asthma in young adulthood: the Odense Schoolchild Study. Eur Respir J. 2000;16(5):866-70.
193. Virchow JC, Crompton GK. Dal Negro R, et al. Importance of inhaler devices in the management of airway disease. Respir Med. 2008;102:10-9.
194. Wieshammer S, Dreyhaupt J. Dry powder inhalers: which factors determine the frequency of handling errors? Respiration. 2008;75(1):18-25.
195. Allen SC, Warwick-Sanders M, Baxter M. A comparison of four tests of cognition as predictors of inability to learn to use a metered dose inhaler in old age. Int J Clin Pract. 2009;63(8):1150-3.
196. 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(5):510-3.
197. Quinet P, Young CA, Héritier F. The use of dry powder inhaler devices by elderly patients suffering from chronic obstructive pulmonary disease. Ann Phys Rehabil Med. 2010;53(2):69-76.
198. MacLaughlin EJ, Raehl CL, Treadway AK, et al. Assessing medication adherence in the elderly: which tools to use in clinical practice? Drugs Aging. 2005;22(3):231-55.
199. Rand CS. Patient adherence with COPD therapy. Eur Respir Rev. 2005;14(96):97-101.
200. Bozek A, Jarzab J. Adherence to asthma therapy in elderly patients. J Asthma. 2010;47(2):162-5.
201. DiMatteo MR. Variations in patients' adherence to medical recommendations: a quantitative review of 50 years of research. Med Care. 2004;42(3):200-9.
202. Horne R. Compliance, adherence, and concordance - implications for asthma treatment. Chest. 2006;130(1 Suppl):65S-72S.
203. Jenkins L, Britten N, Stevenson F, et al. Developing and using quantitative instruments for measuring doctor-patient communication about drugs. Patient Educ Couns. 2003;50(3):273-8.
204. Irwin RS, Richardson ND. Patient-Focused Care; using the right tools. Chest. 2006;130:73S-82S.
205. Marin L, Colombo P, Bebawy M, et al. Chronic obstructive pulmonary disease: patho-physiology, current methods of treatment and the potential for simvastatin in disease management. Expert Opin Drug Deliv. 2011;8(9):1205-20.
206. Stead LF, Perera R, Bullen C, et al. Nicotine replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews. 2008;(1):CD000146.
207. Jimenez Ruiz CA, Ramos Pinedo A, Cicero Guerrero A, et al. Characteristics of COPD smokers and effectiveness and safety of smoking cessation medications. Nicotine Tob Res. 2012;17:17.
208. Pesek R, Lockey R. Vaccination of adults with asthma and COPD. Allergy. 2011;66(1):25-31.