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'Dickensian' lung disease rates on the rise in UK pensioners

The number of people diagnosed with bronchiectasis, a lung condition thought to be a 'disease of the past', has risen considerably in the past decade and now affects more than 1% of UK pensioners, according to a new study in the European Respiratory Journal.

Bronchiectasis is a disease in which the airways taking air into the lungs are damaged. It can be caused by a previous chest infection, weaknesses of the immune system and by conditions that cause inflammation of the airways such as rheumatoid arthritis.

The damaged airways are less able to clear mucus and bacteria away, causing recurrent chest infections. The patients cough up mucus and blood, and develop shortness of breath and sometimes respiratory failure. The disease is incurable and although the resulting infections can be treated with antibiotics, resistant bacteria are becoming an increasing problem.

Researchers from the London School of Hygiene & Tropical Medicine, UCL, University College London Hospitals (UCLH) NHS Foundation Trust, and Imperial College London used anonymised GP records covering 14 million patients from across the UK to identify those with a diagnosis of bronchiectasis.

They found that bronchiectasis is surprisingly common and becoming commoner, especially in older people. The disease affected approximately 0.6% of people aged 70 or over in 2004, but this increased to 1.2% in 2013. The condition was more common in women and among people with higher socio-economic status. Furthermore, the mortality rates in people with bronchiectasis are twice as high as mortality rates in the general population.

The study found that 42% of people with bronchiectasis also had asthma and 36% had chronic obstructive pulmonary disease (COPD). 6.9% of bronchiectasis patients also had HIV, a much higher proportion than expected.

Lead author Dr Jennifer Quint, who carried out the study while at the London School of Hygiene & Tropical Medicine, said: "The high prevalence of bronchiectasis in people with asthma and COPD is an important finding. Whether the diagnosis of bronchiectasis precedes or follows the diagnosis of asthma or COPD is important to investigate next as it may help to guide longer term management in these patients."

The research was funded by the Medical Research Council and National Institute for Health Research.

Publication

JK Quint, ERC Millett, M Joshi, V Navaratnam, SL Thomas, JR Hurst, L Smeeth, JS Brown. Changes in the incidence, prevalence and mortality of bronchiectasis in the UK from 2004-2013: a population based cohort study. European Respiratory Journal. DOI: 10.1183/13993003.01033-2015

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