Gareth Walters1, Alastair
Robertson1, Vicky Moore1 and Sherwood Burge1
1Occupational Lung Disease
Unit, Birmingham Heartlands Hospital, Birmingham, West Midlands, United
Kingdom
Background
Early detection and diagnosis
of chronic
obstructive pulmonary disease (COPD) is essential to maintain patients'
physical function. We have established a novel COPD screening system
for early diagnosis and treatment of 50- to 80-year-old local residents
with an FEV1% of <70%.
Objective
To verify the efficacy of
this medical
examination system according to changes in physical function during a
5-year intervention period.
Methods
All participants (21 patients
with COPD
and 25 healthy subjects with an FEV1% of ≥70%) were inhabitants
of Matsuura, Nagasaki Prefecture and underwent community medical
examinations in 2006 and 2011. For 5 years, pulmonary function tests
were performed once yearly, and patient education was implemented two
to four times yearly. The evaluation items were age, body mass index,
pulmonary function test results (VC, %VC, FVC, FEV1, %FEV1, and FEV1%),
the variation of 1 year, and grip strength.
Results
Patients with COPD were
significantly
older than healthy subjects, while all patients' pulmonary function was
significantly lower than that of healthy subjects. The %VC decreased at
a significantly lower rate in the patients. The FVC and FEV1 showed a
similar tendency; however, the rate of grip strength decline was
significantly higher in the patients.
Conclusions
Pulmonary function and grip
strength
decreased with age in both the patients and healthy subjects. However,
the COPD interventions effectively suppressed the decrease in pulmonary
function in the patients to a greater degree than the normal
age-associated decline. COPD examination is now optional in Japan, but
we hope that local residents become obligated to undergo the
examination to allow for early diagnosis and treatment of potential
COPD.