Bronchiectasis Cases Rising Among Older People in the UK

Bronchiectasis Cases Rising Among Older People in the UK

A new study reported that an increasing number of people in the United Kingdom are being diagnosed with bronchiectasis, a lung disease long thought a thing of the past, with nearly 1% of all U.K. pensioners affected. The research, titled “Changes in the incidence, prevalence and mortality of bronchiectasis in the UK from 2004 to 2013: a population-based cohort study” and recently published in the European Respiratory Journal, was led by scientists at the University College London (UCL), Imperial College London, and the London School of Hygiene and Tropical Medicine.

Bronchiectasis is a disease that damages the airways, and is generally caused by previous chest infections or a weakened immune system and conditions such as rheumatoid arthritis. As damaged airways are less able to clear mucus and bacteria, chest infections reoccur, and patients with bronchiectasis may experience cough with mucus and blood, shortness of breath or, less frequently, respiratory failure. The infections are treated with antibiotics, but bacteria are becoming increasingly resistant.

This research drew on general practitioner (GP) records covering 14 million patients from across the U.K. Results showed that bronchiectasis is becoming surprisingly common, particularly among older people. In 2004, the condition was estimated to affect 0.6% of individuals age 70 or older, and 1.2% in 2013, just nine years later. Women were found to be more  affected by the disease, as well as people with a higher income and social status, and mortality rates in bronchiectasis patients were double that of the general population.

“Bronchiectasis is historically associated with untreated chest infections when antibiotics were not readily available,” said the study’s senior author Dr. Jeremy Brown, Professor of Respiratory Infection at UCL and consultant at University College London Hospitals. “We found that the disease has had a resurgence in the recent years, particularly among more well-off members of society. This could be partly down to improved diagnosis in these groups, but whatever the reason we need better treatment options for patients.”

The Health and Social Care Information Centre released data showing over 12,000 people were hospitalized with  bronchiectasis in 2013-14, most of them over 60 years of age.

The study also found that 42% of bronchiectasis patients had asthma, 36% had chronic obstructive pulmonary disease (COPD), and 6.9% had HIV. “The high prevalence of bronchiectasis in people with asthma and COPD is an important finding,” concluded the study’s lead author, Dr. Jennifer Quint. “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.”