Is Asthma, COPD Overlap Inevitable in Elderly Patients?

Brian Bizik MS, PA-C, Asthma and Allergy of Idaho and Nevada, Immediate Past President of the American Academy of Physician Assistants in Allergy, Asthma, and Immunology, explained that many patients with COPD have had exposure to tobacco smoke or environmental irritants that caused the COPD, or have genetic COPD, meaning, the patients affected would likely be adults.

As patients get older, this overlap becomes more likely especially in the asthma patients who have had poorly controlled asthma. The longer their asthma goes poorly controlled, the more likely they may have some irreversibility or remodeling going on and start to resemble a COPD patient. Even though they’ve had a long history of asthma, they start to mimic a COPD patient even if they haven’t smoked.

“Thankfully both the Global Initiative for Asthma (GINA) and the Global Initiative for Chronic Obstructive Lung Disease (GOLD) have addressed this, and while I don’t know that we’ll have a set of guidelines, what we’re developing are easy ways to diagnose these patients or at least bring up the topic with patients in hopes of proving an easy template to follow.” Ultimately, the long-term goal is to discover just how well clinicians can treat these patients. Some data support that these ACOS patients do better when treated appropriately than somebody who just has standard COPD.