How Long Can You Live with COPD? Stages, Prognosis, and Tips

COPD diagnosis can be overwhelming. But the good news is that COPD is not a terminal disease. With the right management, you can live for 15-20 years with COPD. The COPD life expectancy varies between individuals and entirely depends on: 

• Your age at the time of diagnosis

• Your overall health

• The stage of COPD when it’s diagnosed

If you’re diagnosed early and take good care of your health, you can live a fuller, longer life with COPD. Even if your condition is more advanced, you can still do many things to feel better and stay active.

Stages of COPD 

There are four stages of COPD (Chronic Obstructive Pulmonary Disease). The earlier the stage, the better the chances of long-term survival. These four stages are classified according to GOLD (Global Initiative for Chronic Obstructive Lung Disease). 

GOLD System

It looks at two main things:

1. How much your lungs are blocked (measured by FEV1, the amount of air you can blow out in 1 second). 

2. How much do your symptoms affect your daily life (such as shortness of breath and flare-ups). 

Here is the overview of the life expectancy of patients with COPD at the age of 65 who have never smoked.
 

The GOLD system also classifies the disease into 5 groups (A–D) based on the following:

• How bad your symptoms are

• How often do you have flare-ups

People in Groups A and B have fewer flare-ups and a lower risk, while those in Groups C and D have more frequent flare-ups. The mortality of patients in Group D is about 36.9% higher than those in Group A. 

The BODE Index: A Better Tool for Predicting Life Expectancy in COPD

BODE looks at four factors to predict how long someone with COPD might live. 

• B – Body Mass Index (BMI): This measures your body weight compared to height. A very low BMI can mean poor nutrition and worse outcomes.

• O – Obstruction: This shows how much your airways are blocked, based on your FEV1. It’s measured with a breathing test called spirometry.

• D – Dyspnea: This means how short of breath you feel during daily activities. More breathlessness usually means a more severe stage of COPD.

• E – Exercise Capacity: This is measured by how far you can walk in six minutes. It tells doctors how fit and active your body is.

  
  

Lifestyle Factors Determining How Long Can You Live With COPD

Other than the severity of your disease, here are a few lifestyle factors that impact your quality and quantity of life with COPD.

1. Smoking Status 
   Smoking is the most important indicator of how long you can live with COPD. Here is how smoking damages your lungs:

   • Smoking damages enzymes in the lungs.

   • Damaged enzymes hurt lung tissue and start an immune response.

   • The immune system gets out of balance, so the lungs can’t repair themselves well.

   • This permanently changes the shape of the lungs. Over time, these problems make breathing harder and lower the air you can blow out in one second (FEV1).
     
     

2. Treatment Adherence 
   COPD treatment involves medical and non-medical therapies. It's the combination of both that helps you live longer and improve the quality of your life. It’s important to adhere to your prescribed treatment to live a better life with COPD, which can include any of these: 
   
   

3. Overall Health 
   Your overall health affects how well you respond to COPD treatment. If you have other health problems (called comorbidities), your chances of living longer may be lower. It will be difficult to have a quality life if you have any of the following conditions with COPD:

   • Heart disease 

   • Cancer 

   • Diabetes

   • Anxiety or depression

   Even if you are taking care of these conditions, the risk of death is still three times higher than in those who don’t have comorbidities.
   
   

4. Nutrition & Weight
   Your weight has a direct relation to determining how long you are going to live with COPD. This means that being underweight can lower your life expectancy, and being slightly overweight may actually help people with COPD live longer. Here is how:

   • Breathing takes up about 50% of your energy when you have COPD

   • If you are malnourished or not eating enough, your body has less energy

   • Not getting enough calories leads to muscle loss and weakness.

   • If your body is weak and low on energy, you may not have the strength to breathe properly, which can lead to flare-ups (exacerbations).
     
     

5. Physical Activity
   You can expect to have a quality of life with COPD if you are physically active. That is why your exercise capacity is part of the BODE predictors of survival. Here is how replacing 30 minutes of sitting with physical activity can improve shortness of breath and exacerbations:

   • Makes your lungs more efficient at breathing

   • Improves your body’s ability to take in oxygen and deliver it to your organs

   • This, in turn, improves breathing 

   Research suggests that people who stay physically active have a 47% lower risk of dying within 12 months of leaving the hospital.
   
   

Tips on improving

Living longer with COPD requires following a treatment plan that includes taking your medicine, making healthy choices, and staying away from substances that can hurt your lungs. Here is a quick overview of these tips:

1. Smoking cessation can help slow down the decline in FEV1

2. Use your inhalers every day as prescribed. These help open your airways and reduce swelling.

3. Act fast if symptoms get worse. Early treatment for flare-ups (exacerbations) can prevent serious problems.

4. Infections can make COPD much worse, so make sure you are vaccinated for flu, pneumonia, and COVID-19

5. Staying active can improve breathing, boost energy, and lower your risk of flare-ups and hospital visits.

6. Take care of your mental health

7. If your doctor gives you oxygen, use it exactly as told.

Reducing the risk of death from COPD starts with early diagnosis and sticking to your treatment plan. It's important to see your doctor regularly, especially before and after traveling, or if you've had a flare-up. Staying on top of your care can make a big difference in how well you live with COPD.

Frequently Asked Questions about COPD Life Expectancy

• Can you live 20 years with COPD?
  It entirely depends on the patients. If you follow your treatment plan, quit smoking, and adopt a healthy lifestyle, you can increase your chances of living longer even with COPD. However, if you have severe COPD, continue to smoke, or live a sedentary (inactive) lifestyle, your risk of early death is much higher,  especially if you also have other health problems (comorbidities).

  
  

• Can COPD be reversed?
  While you can’t reverse the damage already done to your lungs, you can still improve how well you breathe. Taking your medications regularly and sticking to pulmonary rehab can help:

  • Open up your airways

  • Reduce flare-ups (exacerbations)

  • Make breathing easier over time

    
    

• What's the most common cause of death in COPD?
  The most common cause of death among people living with COPD is the presence of other health conditions. For instance, 

  • Heart disease: COPD can trigger inflammation throughout the body, which increases the risk of heart problems.

  • Lung cancer: People with COPD are at higher risk of developing lung cancer.

  Additionally, frequent exacerbations worsen the lungs' functioning, leading to respiratory failure.
  
  

• How long does COPD last?
  COPD is a lifelong disease. While it does not have a cure, you can still manage it by taking your medications on time, following pulmonary rehab, and adopting a healthier lifestyle.

  
  

• Can you get COPD if you never smoked?
  Yes, you can develop COPD even if you have never smoked. About 50% of people who have their lungs malfunction get COPD because of non-smoking factors such as:

  • Genetics (deficiency of Alpha-1 Antitrypsin)

  • Second-hand smoke

  • Prolonged exposure to harmful particles or gases in the environment

  • Air pollution
    
    

• What is the best medicine for COPD?
  The best medicine for COPD can vary from person to person. It depends on the severity of the disease and your specific symptoms. In most cases, doctors start with bronchodilators, which help open the airways and make breathing easier. 
  However,  triple therapy is recommended for people with more advanced COPD or those at higher risk of flare-ups.
  
  

• At what stage of COPD requires oxygen?
  Oxygen therapy is usually prescribed at Stage 3 or 4 of COPD when the lungs can no longer provide enough oxygen to the body, leading to respiratory failure.

References

1. Respiratory Research. 2009. BODE index versus GOLD classification for explaining anxious and depressive symptoms in patients with COPD – a cross-sectional study: https://pmc.ncbi.nlm.nih.gov/articles/PMC2626579/

2. International Journal of Chronic Obstructive. 2009. Pulmonary Disease. Life expectancy and years of life lost in chronic obstructive pulmonary disease: Findings from the NHANES III Follow-up Study: https://pmc.ncbi.nlm.nih.gov/articles/PMC2672796/

3. Indian Journal of Critical Care Medicine. 2024. Factors Affecting Survival in Severe and Very Severe COPD after Admission in ICUs of Tertiary Care Centers of India (FAST COPD): Study Protocol for a Multicentric Cohort Study: https://pmc.ncbi.nlm.nih.gov/articles/PMC11310678/