Risk profile of young adults with chronic obstructive pulmonary disease

Background — COPD risk profiles have been described in populations comprised of or including older adults, leaving factors associated with COPD in younger adults overlooked. We aimed to determine patient profiles of physician diagnosed COPD in younger adults.

Methods — A cohort study was conducted using population-based survey data linked to health administrative data from Ontario, Canada from 2007 to 2018. Younger adults 35 to 55 years newly diagnosed with COPD by physicians were matched to controls without physician diagnosed COPD. Multivariable conditional logistic regression models were used to identify statistically significant predictors of COPD. To contextualize results, the analysis was repeated in older adults.

Findings — There were 1094 younger adults with new physician diagnosed COPD. In adjusted analysis, previous influenza or pneumonia, higher level of comorbidity, a mental health condition and a history of asthma independently predicted COPD diagnosis in younger adults. With the exception of mental health conditions, these same variables predicted COPD diagnosis in older adults. However, male sex, lower income, a history of respiratory disease other than asthma, and being overweight or underweight predicted COPD diagnosis in older but not in younger adults.

Interpretation — Having a mental health condition was associated with physician diagnosed COPD in younger adults while male sex, lower income, a history of respiratory disease other than asthma, and being overweight or underweight did not. This new knowledge can be used to dispel stereotypes about COPD. They also suggest that different screening criteria should be considered for younger adults.