COPD and associated comorbidities: the numbers

Number of comorbid chronic conditions in people with COPD

Based on self-reported data from the 2014–15 National Health Survey (NHS), an estimated 600,300 Australians (2.6% of the population) have COPD, many of who are aged 45 and over [1]. Nearly everyone who reported having COPD also reported having one or more of the following selected chronic conditions:

  • arthritis
  • asthma
  • back problems
  • cancer
  • cardiovascular diseases/diseases of the circulatory system (CVD)
  • diabetes
  • mental health problems.

These 7 chronic conditions have been selected because they are common in the general community, pose significant health problems, have been the focus of ongoing national surveillance efforts, and action can be taken to prevent their occurrence [2, 3].

Additional chronic conditions that are commonly found in people with COPD, and that can impact on COPD, include chest infections, bronchiectasis (a condition in which the airway walls are damaged and the person has excessive mucus production and frequent chest infections), obstructive sleep apnoea and osteoporosis [4].

Of those who reported having COPD, 90.6% had at least one other chronic condition while just 9.1% had COPD only (Figure 1). 1 in 5 (20.5%) reported one other chronic condition and over 2 in 3 (70.1%) reported two or more other chronic conditions.

Figure 1: Comorbidity of selected chronic conditions in people with COPD, 2014–15

Note: The 7 other selected chronic conditions include arthritis, asthma, back problems, cancer, cardiovascular disease, diabetes and mental health.

Source: ABS National Health Survey, 2014–15 (First results and customised report ABS 2016) (Data table).

Types of comorbid chronic conditions in people with COPD

Among people with COPD:

  • 37.9% reported mental and behavioural problems (compared with 17.0% of people without COPD)
  • 51.9% reported arthritis (compared with 14.3% for people without COPD)
  • 37.7% reported back problems (compared with 15.6% for people without COPD) (Figure 2).

Figure 2: Prevalence of other chronic conditions in people with and without COPD, 2014–15

Note: Proportions do not total 100% as one person may have more than one additional diagnosis.

Source: ABS National Health Survey, 2014–15 (First results and customised report ABS 2016 (Data table).

COPD comorbidities by age

The development of COPD occurs over many years and therefore mainly affects middle-aged (those aged 45–64) and older people (65 and over).

For people aged 45–64 with COPD:

  • 58.2% reported arthritis
  • 47.2% reported asthma
  • 47.1% reported CVD.

People aged 45–64 with COPD, compared to those without COPD of the same age, were:

  • 2.4 times as likely to report arthritis
  • 4.8 times as likely to report asthma
  • 1.8 times as likely to report CVD (Figure 3).

Figure 3: Prevalence of other chronic conditions in people aged 45–64 with and without COPD, 2014–15

Note: Proportions do not total 100% as one person may have more than one additional diagnosis.

Source: ABS National Health Survey, 2014–15 (First results and customised report ABS 2016) (Data table).

Among older people (aged 65 and over) with COPD:

  • 73.3% reported CVD
  • 67.8% reported arthritis
  • 41.2% reported back problems.

Older people (aged 65 and over) with COPD, compared to those without COPD of the same age, were:

  • 1.3 times as likely to report CVD
  • 1.4 times as likely to report arthritis
  • 1.7 times as likely to report back problems (Figure 4).

Figure 4: Prevalence of other chronic conditions in people aged 65 and over with and without COPD, 2014–15

Note: Proportions do not total 100% as one person may have more than one additional diagnosis.

Source: ABS National Health Survey, 2014–15 (First results and customised report ABS 2016) (Data table).

Data notes

The comorbidity data presented here are based on self-reported data from the NHS. When interpreting self-reported data, it is important to recognise that because we rely on respondents providing accurate information, the outputs may not always be a true reflection of the situation.

In the 2014–15 NHS, the number and proportion of persons with long-term health conditions is presented as those who have "a current medical condition which has lasted, or is expected to last, for 6 months or more, unless otherwise stated" [1]. For all of the chronic conditions included in this analysis, except for back problems and COPD, the NHS participants were asked whether they have long-term health conditions diagnosed by a doctor or nurse. The respondents were not asked whether they were told they had back problems or COPD by a doctor or nurse. This difference in the questions may affect the estimated prevalence of the conditions.

In order to focus on comorbidity by COPD status, this report did not adjust for age-structure when comparing people with self-reported COPD and those without. It is possible that within the same age-group, those with COPD are older on average than those without, which would make the former more likely to have comorbidity due to older age.

References

  1. Australian Bureau of Statistics (ABS) 2015. National Health Survey: First Results, 2014–15. ABS Cat. no. 4364.0.55.001. Canberra: ABS.
  2. Australian Institute of Health and Welfare (AIHW) 2015. Cardiovascular disease, diabetes and chronic kidney disease—Australian facts: risk factors. Cardiovascular, diabetes and chronic kidney disease series no. 4. Cat. no. CDK 4. Canberra: AIHW.
  3. AIHW 2013. Risk factors contributing to chronic disease. Cat No. PHE 157. Canberra: AIHW.
  4. Lung Foundation Australia. 2015. COPD-X Guidelines – Version 2.44. Viewed 16 February 2016.