Average Age at Death from COPD in the United States: 1980–85, 1990–95, 2000–05

Abstract

COPD represents an important public health challenge, in the US and globally, that is both preventable and treatable. We describe the average age at death from COPD, a leading cause of death in the US, using data from the National Vital Statistics System for the periods 1980–85, 1990–95, and 2000–05. Average age at death from COPD increased 3–4 years between 1980–85 and 2000–05 for men and women as well as for Whites and Blacks.

Keywords:

• pulmonary disease
• chronic obstructive
• mortality
• statistics

Chronic obstructive pulmonary disease (COPD), the fourth leading cause of morbidity and mortality in the US, represents an important public health challenge that is both preventable and treatable ([1]). We describe the average age at death from COPD during 1980–85, 1990–95, and 2000–05 using data from the Centers for Disease Control and Prevention's (CDC) online compressed mortality file of the National Vital Statistics System ([2]). We identified the number of deaths for which COPD was the underlying cause using International Classification of Diseases, Ninth Revision (ICD-9) codes 490 (bronchitis not specified as acute or chronic), 491 (chronic bronchitis), 492 (emphysema), and 496 (chronic airway obstruction, not elsewhere classified) to identify COPD cases during 1980–85 and 1990–95. International Classification of Diseases, Tenth Revision (ICD-10) codes J40 (bronchitis not specified as acute or chronic), J41 (simple and mucopurulent chronic bronchitis), J42 (unspecified chronic bronchitis), J43 (emphysema), and J44 (other chronic obstructive pulmonary disease) were used to identify COPD cases during 2000–05 ([3]).

The number of deaths was obtained for each of 13 age groups (< 1, 1–4, 5–9, 10–14, 15–19, 20–24, 25–34, 35–44, 45–54, 55–64, 65–74, 75–84, and 85+ years) for each period via CDC's online compressed mortality file of the National Vital Statistics System ([2]). We multiplied the age-specific number of deaths by the lower and upper bounds and median of each age range. For example, in 1980–85, 10,900 persons aged 45–54 years died from COPD; we multiplied this number by 45 (lower bound), 49.5 (median of age range), and 54 (upper bound) to obtain the values 490,500; 539,550; and 588,600; respectively. Values were then summed across all age groups and divided by the total number of deaths (359,802 in 1980–85; 537,554 in 1990–95; 718,544 in 2000–05) to obtain an average age at death. For persons who died during the first year of life, the lower bound and median were set at 0.5 and the upper bound was set at 0.9. For persons aged ≥85 years at the time of death, the lower bound was set at 85 years; the median, 89.5 years; and the upper bound, 94 years.

A comparison of the relative frequency of age at death from COPD across the three periods suggests a shift towards older age groups (Figure 1). Age-specific mortality rates from COPD are also shown. Overall, the range for average age at death from COPD increased 3–4 years between 1980–85 and 2000–05 (Table 1). Similar increases in the average age at death from COPD were observed for men, women, whites and blacks. Similar to other disease conditions, blacks who died from COPD were younger on average than whites at the time of death.

Table 1 Average age at death from chronic obstructive pulmonary disease (COPD): United States, 1980-85, 1990-95, 2000-05

	Men	Women	White	Black	Overall – COPD	Overall – All Causes
1980–85	73.0 (68.5, 77.5)	72.6 (68.1, 77.1)	73.1 (68.6, 77.6)	68.8 (64.3, 73.2)	72.9 (68.4, 77.4)	68.4 (64.1, 72.7)
1990–95	74.8 (70.3, 79.3)	75.4 (70.9, 79.9)	75.3 (70.8, 79.8)	71.7 (67.2, 76.2)	75.1 (70.6, 79.6)	70.0 (65.7, 74.4)
2000–05	75.9 (71.4, 80.4)	77.3 (72.8, 81.8)	76.8 (72.3, 81.3)	73.1 (68.6, 77.6)	76.6 (72.1, 81.1)	71.9 (67.5, 76.3)

*COPD identified using ICD-9 codes 490, 491, 492, and 496 for the periods 1980–85 and 1990–95 and ICD-10 codes J40, J41, J42, J43, J44 during the period 2000–05. Estimates of the average age at death using the lower and upper bounds of age-specific number of COPD deaths were computed and are reported in parentheses.

Figure 1 Age distribution of deaths and age-specific mortality rates for chronic obstructive pulmonary disease (COPD)*: United States, 1980–85, 1990–95, 2000–05. *COPD identified using ICD-9 codes 490, 491, 492, and 496 for the periods 1980–85 and 1990–95 and ICD-10 codes J40, J41, J42, J43, J44 during the period 2000–05.

Globally, the COPD burden is projected to increase in the coming decades due to continued exposure to COPD risk factors and aging of the population ([4]). Technological advances affecting diagnosis, treatment and management of the disease and other related diseases as well as changes in age-specific incidence of COPD and exposure to risk factors (e.g., smoking and passive smoke exposure, indoor and outdoor air pollution) for the disease are partly responsible for shifts in the age distribution of deaths from COPD. Although current evidence does not support population screening using office spirometry to detect COPD, patients should be identified and treated as early as possible in the course of the disease ([5]). Education of physicians on the availability of clinical practice guidelines for the diagnosis and management of COPD should continue. Moreover, further efforts to improve public recognition of COPD as a public health problem and to increase awareness of COPD symptoms are needed.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. This work was completed by employees of the U.S. Government acting in their official capacities. As such, it is in the public domain and not subject to copyright restrictions.

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