Chronic Obstructive Pulmonary Disease (COPD) in Younger Adults: Challenges and Considerations – A Review

Year : 2025 | Volume : 15 | Issue : 03 | Page : 08 19
    By

    Sajad Ali Dar,

  • Kamalesh Mistry,

  • Dhananjay Mistry,

  • Md. Aftab Alam,

  • Komal Maliwal,

  • Neha Nahid,

  1. Research Scholar, Department of Pharmacy, Faculty of Pharmaceutical Science, Mewar University, Gangrar, Chittorgarh, Rajasthan, India
  2. Assistant Professor, Department of Pharmacy, Faculty of Pharmaceutical Science, Mewar University, Gangrar, Chittorgarh, Rajasthan, India
  3. Lecturer, Department of Pharmacy, Faculty of Pharmaceutical Science, Mewar University, Gangrar, Chittorgarh, Rajasthan, India
  4. Lecturer, Department of Pharmacy, Faculty of Pharmaceutical Science, Mewar University, Gangrar, Chittorgarh, Rajasthan, India
  5. Lecturer, Department of Pharmacy, Faculty of Pharmaceutical Science, Mewar University, Gangrar, Chittorgarh, Rajasthan, India
  6. Lecturer, Department of Pharmacy, Faculty of Pharmaceutical Science, Mewar University, Gangrar, Chittorgarh, Rajasthan, India

Abstract

Chronic Obstructive Pulmonary Disease (COPD) phenomenon rapidly converting into chronic significant health issues for many young adults. A disease calculated for older age gives way to early-onset COPD, which creates new issues for diagnosing and treating the illness and even interacts with the quality of life. The article reviews the epidemiology, risk factors, pathophysiology, clinical presentation, and treatment considerations related to this set of conditions. From those risk factors, early-onset COPD would have some other unique ones in terms of genetic predisposition, environmental pollutants, work hazards, and new smoking trends such as vaping. The pathophysiology may be attributed to complex interplay between airway inflammation, small airway disease, impaired lung development, and oxidative stress. Diagnosing COPD in younger adults is riddled with problems, such as atypical symptoms and the unavailability of awareness among health care providers for wrong diagnosis with asthma or other respiratory condition. Management techniques are threatened with delayed diagnosis, absence of age-specific treatment guidelines, nonadherence to set treatment regimes, and other psychosocial factors. It directly threatens the quality of life among younger adults, with adverse effects in terms of affecting physical performance, psychological domain, work opportunities, and natural increase in health costs. Future research efforts should strengthen early detection tools, further develop personalized treatment pathways, and seek to introduce novel therapies and psychosocial dimensions to disease-oriented research agendas. Longitudinal cohort studies and digital health solutions can be brought together to help develop an understanding and response in the management of COPD among younger populations. In young adults, it is so vital to create greater consciousness, promote early intervention, and tailor preventive measures to alleviate the increasing burden of illness due to COPD.

Keywords: Chronic Obstructive Pulmonary Disease (COPD), Younger Adult, Early-onset COPD, Risk Factors, Pathophysiology, Diagnosis, Management, Quality of Life

[This article belongs to Research and Reviews: A Journal of Pharmacology ]

How to cite this article:
Sajad Ali Dar, Kamalesh Mistry, Dhananjay Mistry, Md. Aftab Alam, Komal Maliwal, Neha Nahid. Chronic Obstructive Pulmonary Disease (COPD) in Younger Adults: Challenges and Considerations – A Review. Research and Reviews: A Journal of Pharmacology. 2025; 15(03):08-19.
How to cite this URL:
Sajad Ali Dar, Kamalesh Mistry, Dhananjay Mistry, Md. Aftab Alam, Komal Maliwal, Neha Nahid. Chronic Obstructive Pulmonary Disease (COPD) in Younger Adults: Challenges and Considerations – A Review. Research and Reviews: A Journal of Pharmacology. 2025; 15(03):08-19. Available from: https://journals.stmjournals.com/rrjop/article=2025/view=217449


References

  1. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. 2024 Report.
  2. Svanes, C., Sunyer, J., Plana, E., et al. Early life origins of chronic obstructive pulmonary disease.
  3. Thorax. 2010; 65(1):14-20.Hogg, J. C., & Timens, W. The pathology of chronic obstructive pulmonary disease.
  4. Annu Rev Pathol. 2009; 4:435-459.Soriano, J. B., Polverino, F., & Cosio, B. What is early COPD and why is it important?
  5. Eur Respir J. 2018; 52(6):1801448.Martinez, F. J., Han, M. K., Allinson, J. P., et al. At the root: Defining and halting disease progression in COPD.
  6. Am J Respir Crit Care Med. 2018; 197(5):584-585.Mannino, D. M., Buist, A. S. Global burden of COPD: Risk factors, prevalence, and future trends.
  7. Lancet. 2007; 370(9589):765-773.Lange, P., Celli, B., Agustí, A., et al. Lung-function trajectories leading to chronic obstructive pulmonary disease.
  8. N Engl J Med. 2015; 373(2):111-122.Celli, B. R., Wedzicha, J. A. Future directions in COPD research.
  9. Lancet. 2019; 393(10185):1472-1487.Burney, P. G., Patel, J., Newson, R., et al. Global and regional trends in COPD prevalence: Systematic analysis.
  10. Thorax. 2021; 76(5):500-509.Amaral, A. F., Strachan, D. P., Burney, P. G., et al. Early-life factors and lung function trajectories leading to chronic obstructive pulmonary disease.
  11. Am J Respir Crit Care Med. 2015; 191(12):1432-1440.Stoller, J. K., Aboussouan, L. S. Alpha-1 antitrypsin deficiency.
  12. Lancet. 2005; 365(9478):2225-2236.Silverman, E. K., Sandhaus, R. A. Alpha1-antitrypsin deficiency.
  13. N Engl J Med. 2009; 360(26):2749-2757.Wilk, J. B., Shrine, N. R., Loehr, L. R., et al. Genome-wide association studies identify novel susceptibility loci for COPD.
  14. Am J Respir Crit Care Med. 2012; 186(8):738-746.Burney, P. G., Patel, J., Newson, R., et al. Global and regional trends in COPD prevalence: Systematic analysis.
  15. Thorax. 2021; 76(5):500-509.Po, J. Y., FitzGerald, J. M., Carlsten, C. Respiratory disease associated with solid biomass fuel exposure in rural women and children: Systematic review and meta-analysis.
  16. Thorax. 2011; 66(3):232-239.Blanc, P. D., Annesi-Maesano, I., Balmes, J. R., et al. The occupational burden of nonmalignant respiratory diseases: An official American Thoracic Society and European Respiratory Society Statement.
  17. Am J Respir Crit Care Med. 2019; 199(11):1312-1334.Gotts, J. E., Jordt, S. E., McConnell, R., et al. What are the respiratory effects of e-cigarettes?
  18. BMJ. 2019; 366:l5275.Ghosh, A., Coakley, R. D., Mascarenhas, J. B., et al. Chronic e-cigarette exposure alters the human bronchial epithelial proteome.
  19. Am J Respir Crit Care Med. 2018; 198(1):67-76.Marcon, A., Pesce, G., Calciano, L., et al. Trends in smoking initiation in Europe over 40 years: A retrospective cohort study.
  20. PLoS One. 2018; 13(8):e0201881.Tashkin, D. P. Marijuana smoking and COPD: A review.
  21. Chronic Obstr Pulm Dis. 2018; 5(1):52-68.Stern, D. A., Morgan, W. J., Wright, A. L., et al. Poor airway function in early infancy and lung function by age 22 years: A non-selective longitudinal cohort study.
  22. Lancet. 2007; 370(9589):758-764.Martinez, F. D. Early-life origins of chronic obstructive pulmonary disease.
  23. N Engl J Med. 2016; 375(9):871-878.Stocks, J., Sonnappa, S. Early life influences on the development of chronic obstructive pulmonary disease.
  24. Ther Adv Respir Dis. 2013; 7(3):161-173.Barnes, P. J. Inflammatory mechanisms in patients with chronic obstructive pulmonary disease.
  25. J Allergy Clin Immunol. 2016; 138(1):16-27.Christenson, S. A., Steiling, K., van den Berge, M., et al. Asthma–COPD overlap: What we know and what we don’t.
  26. Eur Respir J. 2019; 54(3):1900905.Agustí, A., Faner, R. Lung function trajectories in health and disease.
  27. Lancet Respir Med. 2019; 7(4):358-364.McDonough, J. E., Yuan, R., Suzuki, M., et al. Small-airway obstruction and emphysema in chronic obstructive pulmonary disease.
  28. N Engl J Med. 2011; 365(17):1567-1575.Vestbo, J., Edwards, L. D., Scanlon, P. D., et al. Changes in forced expiratory volume in 1 second over time in COPD.
  29. N Engl J Med. 2011; 365(13):1184-1192.Stockley, R. A., Mannino, D., Barnes, P. J. COPD in perspective.
  30. Chest. 2021; 160(5):1306-1318.Martinez, F. D. Early-life origins of chronic obstructive pulmonary disease.
  31. N Engl J Med. 2016; 375(9):871-878.Stocks, J., Sonnappa, S. Early life influences on the development of chronic obstructive pulmonary disease.
  32. Ther Adv Respir Dis. 2013; 7(3):161-173.Alder, J. K., Guo, N., Kembou, F., et al. Telomere length is a determinant of emphysema susceptibility.
  33. Am J Respir Crit Care Med. 2011; 184(8):904-912.Kirkham, P. A., Barnes, P. J. Oxidative stress in COPD.
  34. Chest. 2013; 144(1):266-273.Hwang, J. H., Lyes, M., Sladewski, K., et al. Electronic cigarette inhalation alters innate immune responses and airway cytokines.
  35. Am J Respir Cell Mol Biol. 2016; 54(6):801-808.MacNee, W. Oxidants and COPD.
  36. Thorax. 2001; 56(Suppl 2):ii43-ii48.Ryter, S. W., Chen, Z. H., Kim, H. P., et al. Mitochondrial dysfunction in COPD and lung cancer: The connection and the bioenergetics.
  37. Am J Respir Cell Mol Biol. 2011; 44(6):667-675.Aaron, S. D., Boulet, L. P., Reddel, H. K. Diagnosing airway diseases: COPD, asthma, and asthma–COPD overlap syndrome (ACOS).
  38. Chest. 2017; 151(6):1331-1348.Miravitlles, M., Barrecheguren, M., Román-Rodríguez, M. Frequency and characteristics of different clinical COPD phenotypes in primary care.
  39. Int J Chron Obstruct Pulmon Dis. 2015; 10:925-932.Han, M. K., Agusti, A., Calverley, P. M., et al. Chronic obstructive pulmonary disease phenotypes: The future of COPD.
  40. Am J Respir Crit Care Med. 2010; 182(5):598-604.Barnes, P. J. Immunology of asthma and chronic obstructive pulmonary disease.
  41. Nat Rev Immunol. 2008; 8(3):183-192.Vestbo, J., Hurd, S. S., Agusti, A. G., et al. Global strategy for the diagnosis, management, and prevention of COPD: GOLD executive summary.
  42. Am J Respir Crit Care Med. 2013; 187(4):347-365.Stern, D. A., Morgan, W. J., Wright, A. L., et al. Lung function decline in individuals with early life respiratory conditions.
  43. N Engl J Med. 2010; 363(6):495-505.De Matteis, S., Jarvis, D., Hutchings, S., et al. Occupation and chronic obstructive pulmonary disease: A systematic review and meta-analysis.
  44. Lancet Respir Med. 2016; 4(5):365-374.Woodruff, P. G., Barr, R. G., Bleecker, E., et al. Clinical significance of symptoms in smokers with preserved pulmonary function.
  45. N Engl J Med. 2016; 374(19):1811-1821.Stanojevic, S., Kaminsky, D. A., Miller, M. R., et al. Reference ranges for spirometry across all ages: A new approach.
  46. Am J Respir Crit Care Med. 2021; 204(4): 497-508.Lynch, D. A., Austin, J. H. M., Hogg, J. C., et al. CT-definable subtypes of chronic obstructive pulmonary disease: A statement of the Fleischner Society.
  47. Radiology. 2015; 277(1): 192-205.Mohamed Hoesein, F. A., Zanen, P., Boezen, H. M., et al. CT-quantified emphysema in male heavy smokers: Association with lung function decline.
  48. Thorax. 2011; 66(9): 782-787.Bafadhel, M., McKenna, S., Terry, S., et al. Acute exacerbations of chronic obstructive pulmonary disease: Identification of biologic clusters and their biomarkers.
  49. Am J Respir Crit Care Med. 2011; 184(6): 662-671.Stockley, R. A., Mannino, D., Barnes, P. J. Alpha-1 antitrypsin deficiency: The forgotten COPD phenotype?
  50. Chest. 2016; 149(3): 831-841.Campos, M. A., Wanner, A., Zhang, G., et al. Trends in the diagnosis of symptomatic patients with alpha-1 antitrypsin deficiency between 1968 and 2003.
  51. Chest. 2005; 128(3): 1179-1186.Nishimura, K., Izumi, T., Tsukino, M., et al. Dyspnea is a better predictor of 5-year survival than airway obstruction in patients with COPD.
  52. Chest. 2002; 121(5): 1434-1440.O’Donnell, D. E., Elbehairy, A. F., Faisal, A., et al. Exertional dyspnea in chronic respiratory disease: The role of the respiratory system.
  53. Clin Chest Med. 2016; 37(3): 525-548.Gibson, P. G., McDonald, V. M., Marks, G. B. Asthma and COPD overlap: A syndrome or a spectrum?
  54. Respirology. 2015; 20(5): 595-603.De Marco, R., Marcon, A., Rossi, A., et al. Asthma, COPD and overlap syndrome: A longitudinal study in young European adults.
  55. Eur Respir J. 2015; 46(3): 671-679.Hines, K. L., Peebles, R. S. Management of the asthmatic smoker.
  56. Curr Opin Pulm Med. 2011; 17(1): 75-82.Saha, S., Malkhen, L., Kunjal, S., et al. Early-life risk factors for chronic obstructive pulmonary disease: Findings from a systematic review and meta-analysis.
  57. Chest. 2021; 159(6): 2242-2255.Lange, P., Celli, B. R., Agusti, A., et al. Lung-function trajectories leading to chronic obstructive pulmonary disease.
  58. N Engl J Med. 2015; 373(2): 111-122.Celli, B. R., Wedzicha, J. A. Future directions in COPD treatment 2019.
  59. Lancet. 2019; 393(10185): 547-549.Waschki, B., Kirsten, A., Holz, O., et al. Physical activity is the strongest predictor of all-cause mortality in patients with COPD.
  60. Chest. 2011; 140(2): 331-342.Pitta, F., Troosters, T., Spruit, M. A., et al. Characteristics of physical activities in daily life in chronic obstructive pulmonary disease.
  61. Am J Respir Crit Care Med. 2005; 171(9): 972-977.Yohannes, A. M., Alexopoulos, G. S. Depression and anxiety in patients with COPD.
  62. Eur Respir Rev. 2014; 23(133): 345-349.Stav, D., Raz, M. Prevalence of depression and anxiety in patients with COPD.
  63. Chest. 2007; 131(3): 718-725.Maurer, J., Rebbapragada, V., Borson, S., et al. Anxiety and depression in COPD: Current understanding and management strategies.
  64. Chest. 2008; 134(4 Suppl): 43S-56S.Eisner, M. D., Blanc, P. D., Yelin, E. H., et al. COPD as a barrier to work: Impact on employment and disability in chronic respiratory disease.
  65. Chest. 2010; 137(3): 659-667.Fletcher, J. M., Sindelar, J. L. The effects of smoking and quitting on workplace absenteeism.
  66. J Hum Resour. 2009; 44(4): 971-990.Ford, E. S., Murphy, L. B., Khavjou, O., et al. Total and state-specific medical and absenteeism costs of COPD among adults in the United States.
  67. Chest. 2015; 147(1): 31-45.Reardon, J. Z., Lareau, S. C., ZuWallack, R. The role of pulmonary rehabilitation in the management of chronic respiratory disease.
  68. Respir Care. 2006; 51(7): 849-858.Spitzer, K. A., Stefan, M. S., Priya, A., et al. Association of depression with hospitalizations and mortality in chronic obstructive pulmonary disease: A systematic review and meta-analysis.
  69. Respir Med. 2019; 151: 1-9.Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of COPD. 2023 Report.
  70. Lopez-Campos, J. L., Tan, W., Soriano, J. B. Global burden of COPD.
  71. Respirology. 2016; 21(1): 14-23.Martinez, F. J., Han, M. K., Allinson, J. P., et al. Recognizing early COPD in younger adults: Implications for diagnosis and management.
  72. Am J Respir Crit Care Med. 2019; 200(5):573-585.Regan, E. A., Lynch, D. A., Curran-Everett, D., et al. Clinical and radiologic disease in smokers with normal spirometry.
  73. JAMA Intern Med. 2021; 181(5): 792-801.Behr, J., Furst, D. E. Pulmonary fibrosis and occupational lung disease: Mechanisms and treatment approaches.
  74. Respirology. 2020; 25(2): 187-197.Stolk, J., Stockley, R. A., Stoel, B. C., et al. Disease-modifying treatments for COPD.
  75. Lancet Respir Med. 2013; 1(6): 453-463.Budden, K. F., Gellatly, S. L., Wood, D. L., et al. Emerging pathogenic links between microbiota and the gut-lung axis.
  76. Nat Rev Microbiol. 2017; 15(1): 55-63.Yohannes, A. M., Alexopoulos, G. S. Depression and anxiety in patients with COPD.
  77. Eur Respir Rev. 2014; 23(133): 345-349.Sohanpal, R., Seale, C., Taylor, S. J., et al. COPD self-management and behavior change: A systematic review.
  78. Chron Respir Dis. 2012; 9(1): 3-25.Al Rajeh, A. M., Hurst, J. R. Monitoring of COPD: A review of current technology and future applications.
  79. Expert Rev Respir Med. 2016; 10(1): 79-86.Blumenthal, J. A., Emery, C. F., Smith, P. J., et al. Exercise training in COPD: What is the evidence for behavioral interventions? Respirology. 2018; 23(1): 80-88.

Regular Issue Subscription Review Article
Volume 15
Issue 03
Received 07/03/2025
Accepted 19/04/2025
Published 23/07/2025
Publication Time 138 Days


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