If you or a family member is one of the millions who has been diagnosed with COPD (chronic obstructive pulmonary disease)—an umbrella term for progressive lung diseases like emphysema and chronic bronchitis—you’re likely to have questions about how it will affect your quality of life and prognosis. Although COPD life expectancy is shorter on average than for people without COPD, many different factors affect an individual’s prognosis. After a COPD diagnosis, working closely with your doctor to monitor your COPD symptoms and treatment can help you understand how your COPD is progressing and—more importantly—how to enjoy a high quality of life for as many years as possible. Learning what affects COPD progression and how your doctor measures it may help you talk with your doctor about your own situation. COPD and the Years Ahead COPD is a major cause of shortened lifespan among Americans. One major study examined life expectancy of people with COPD, and the results showed that smoking played a significant role in how the condition affected people’s lifespans. Smokers with COPD had a very large reduction in life expectancy (nearly 6 years for those in the later phases of the disease plus 3.5 years lost from smoking), while those who had never smoked only had a modest reduction in life expectancy (a little over 1 year). This means the effect of COPD on life expectancy is most extreme in people who smoke. Coexisting conditions play a role too: Heart disease and diabetes have been shown to shorten lifespan in people with a COPD diagnosis. All of this suggests that taking care of your health through proactive steps like quitting smoking and maintaining a healthy diet and exercise regimen can potentially lessen the effect of COPD on your life expectancy. Understanding COPD Progression While there is no way to predict how exactly COPD will affect your life expectancy, there are a handful of tests and evaluations doctors use to monitor the progression of your COPD and estimate your risk of future problems, including exacerbations—COPD flare-ups that require hospitalization. These COPD tools also help guide treatment decisions. GOLD System The Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification system measures your lung function and takes your symptoms into account to help determine how COPD is impacting your life. Spirometry is a lung function test that measures how much air you can forcefully blow out in one second. Your doctor combines this information with how severe your symptoms feel and your history of exacerbations to classify your COPD into a category (A, B, C or D, with A the least severe and D the most severe). COPD classification guides both you and your doctor toward potential therapies based on your current level of functioning. BODE Index The BODE index is another system your doctor may use to determine how COPD may affect your life expectancy. BODE stands for these four measurements: Body mass index (BMI), which takes your weight and height into account to determine whether you are overweight, obese, or underweight Obstruction of airways, which is measured using the same one-second blowing test used in the GOLD system, along with other pulmonary function tests Dyspnea (difficulty breathing), which relies on your rating of how much shortness of breath affects your day-to-day life. Some research shows people who have trouble breathing have a lower life expectancy. Exercise capacity, which is commonly measured by the 6-Minute Walk Test—your doctor tracks the distance you can walk on an indoor, flat surface for six minutes. These results provide you with an approximate survival estimate, which can guide you and your doctor toward choosing an intervention, like nutrition counseling or light daily exercise, to manage your symptoms. A Blood Test to Predict COPD Prognosis Recently, researchers reported a routine blood test may help predict COPD prognosis and life expectancy. One of COPD’s characteristics is systemic inflammation, and your blood can be analyzed to find two different biomarkers of inflammation levels. It will also show how much oxygen and carbon dioxide are in your blood, which indicates how well your lungs are working and whether you might benefit from oxygen therapy. While blood work is not currently a customary way to determine COPD prognosis, it may be part of COPD diagnosis and management in the future. Regardless of the tool your doctor uses, talking about your life expectancy can be scary. But working closely with your doctor can allow you to use this information as a helpful tool to find treatments that can enhance your quality of life and possibly slow the progression of your COPD symptoms.