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Review
. 2017 Mar 24;18(1):5-11.
doi: 10.1002/jgf2.2. eCollection 2017 Mar.

Asthma-COPD overlap syndrome-Coexistence of chronic obstructive pulmonary disease and asthma in elderly patients and parameters for their differentiation

Yoshihiro Tochino  1   2 , Kazuhisa Asai  1 , Taichi Shuto  2 , Kazuto Hirata  1
Affiliations
Review

Asthma-COPD overlap syndrome-Coexistence of chronic obstructive pulmonary disease and asthma in elderly patients and parameters for their differentiation

Yoshihiro Tochino et al. J Gen Fam Med. .

Abstract

Japan is an aging society, and the number of elderly patients with asthma and chronic obstructive pulmonary disease (COPD) is consequently increasing, with an estimated incidence of approximately 5 million. In 2014, asthma-COPD overlap syndrome (ACOS) was defined by a joint project of Global Initiative for Asthma (GINA) committee and the Global Initiative for Chronic Obstructive Lung Disease (GOLD) committee. The main aims of this consensus-based document are to assist clinicians, especially those in primary care or nonpulmonary specialties. In this article, we discussed parameters to differentiate asthma and COPD in elderly patients and showed prevalence, clinical features and treatment of ACOS on the basis of the guidelines of GINA and GOLD. Furthermore, we showed also referral for specialized investigations.

Keywords: asthma; chronic obstructive pulmonary disease; smoking.

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Figures

Figure 1
Figure 1
Percentage with Asthma‐COPD overlap syndrome (ACOS) among the patients with airflow obstruction. Each age group was divided by gender. Prevalence of ACOS patients was increased by age
Figure 2
Figure 2
Annual change of pulmonary functions in healthy control, inactive asthma, and active asthma. Active asthma patients decline their lung function compared to inactive asthma
Figure 3
Figure 3
Drug therapy of Asthma‐COPD overlap syndrome (ACOS), asthma, and chronic obstructive pulmonary disease (COPD). A combination of inhaled corticosteroids (ICS) and bronchodilators, long‐acting muscarinic antagonists (LAMA), or long‐acting beta‐2 agonists is the recommended pharmacological therapy for ACOS. ICS are first‐choice drugs for asthma, while LAMAs are first‐choice drugs for COPD
Figure 4
Figure 4
Guidelines of Global Initiative for Asthma and Global Initiative for Chronic Obstructive Lung Disease showed syndromic approach to disease of chronic airflow limitation. This approach showed from diagnosis of chronic airway disease (STEP 1) to referral for specialized investigations (STEP 5)
See this image and copyright information in PMC

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