Young and Short of Breath: Could It Be COPD?


(123RF)Supermodel Christy Turlington said she had early signs of emphysema at age 31. Singer Amy Winehouse reportedly had early signs too—when she was only 24. Can young people in their 20s and 30s really develop a serious, potentially life-threatening disease most commonly seen in older smokers?

Emphysema is often referred to as chronic obstructive pulmonary disease (COPD), a disorder that can include both emphysema and chronic bronchitis. (COPD patients often have both conditions.) COPD is still rare in people in their 20s or 30s, but the disease—which is characterized by lung damage and difficulty breathing—is occurring at earlier ages than in the past.

“We are seeing more and more COPD in younger people,” says Neil Schachter, MD, a professor of pulmonary medicine and the medical director of the respiratory care department at Mount Sinai Medical Center in New York City. COPD used to affect patients who were mostly in their 50s or 60s, but now diagnoses are on the rise in those in their 40s. "Improved awareness of COPD among both physicians and the public and more sensitive methods for diagnosis are the main reasons that we are recognizing the disease in younger individuals," says Dr. Schachter.

In 2000, 3.9% of the U.S. population between the ages of 25–44 were living with COPD; that number was 7.7% for those between ages 55–64, and 9.5% in people over 74 years of age.

“Although we dont see COPD in children, we do realize now that children who have asthma may be at risk of COPD later in life because of the [lung changes] that result from asthma,” explains Dr. Schachter. Whether you think you're at risk or not, people under 40 can reduce their risk of COPD by avoiding cigarette smoke, dust, and pollution.

When it comes to developing COPD at a young age, there is one especially vulnerable group—those with a rare genetic disorder called alpha-1 antitrypsin deficiency. Only about 100,000 people in the United States have it, but it makes the lungs (and liver) incredibly sensitive to damage and can result in an under-30 diagnosis of COPD (even in otherwise healthy nonsmokers.)

The problem is that many people don't know they have the gene until COPD has been diagnosed. However, if you have family members with COPD, you are at greater risk of being a gene carrier.

Bartolome Celli, MD, a professor of medicine in the pulmonary division of the Tufts University School of Medicine, in Boston, recommends that parents with COPD get tested first to check for deficiency; if they have it, their children should get checked. If you have the deficiency, says Dr. Celli, you can help prevent lung problems by avoiding dusty and smoky environments, eating a healthy diet, and getting vaccinations.

Whether you have a genetic predisposition or not, experts agree that the best way to prevent COPD is to avoid smoking, which can set the stage for a COPD diagnosis in your 40s and 50s. Smoking is responsible for about 75% of COPD deaths, according to the Centers for Disease Control and Prevention.