Fev1 percentage drop?

Hello, although I understand that fev1 will decline in people with copd at what rate does it decline ?

Mine own fev1 as stayed pretty much the same for the last few years give or take 1 or 2% I think this maybe due to my age, I am 43, can I expect to see a faster decline as I get older or is it likely to continue drop by a 1 or 2 % each year ? I am aware that lungs decline naturally with age.

I know that some of the people on here will have a better understanding regarding this than me, it would be great to have your thought and experiences to help me and the other people on here to get a better understanding of our condition.

Kind regards

Warren

21 Replies

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  • Can't help you there hun on specifics but I would have thought that every person is different and can progress at different stages at different times etc so as you are very young (in my opinion!) that stands you in good stead maybe.

    Best person to ask is your respiratory nurse I think.

    take care Warren x

  • Don't be so modest about your level of understanding. Having read your earlier posts I would say you have a pretty good understanding of COPD and its progressoin.

  • I must admit i am obsessed with finding out everything about this condition because i have not been told very much about it by my doctor, thank god for the internet. Although you can read about the progression its not the same as being told about it by people that have it. There is still so much i dont really know copd. Knowledge is power with this condition.

    Hope you all have a nice day

    Kind regards

    Warren

  • We are all the same wanting to know we are doing the most for the longest life with the best quality. Take some time living and enjoying life or what are you living for.

    Nice days to you also :-)

  • All i know is that if you exercise, eat healthily and don't smoke. The deterioration is in line with normal ageing. I don't know what that rate is and I'm not too bothered as I can't stop myself getting older!

    Lynne x

  • Hi Warren,

    Lung function including FEV1 is worked out for people with copd as a percentage of what would be predicted for a healthy person of the same age weight and gender as you.

    So IF we can manage to stabilise the condition through lifestyle stuff as Lynne says, then the decline in FEV1 is at the same rate as healthy people. On a graph this would be a parallel line to healthy people, but below theirs, due to the damage we have that they dont.

    If you google lung function test graph, or something like that, you should find a graph to explain it better than me.

    I cant remember the normal decline rate either.

    Good luck, jean

  • Hmmm - ive always understood that if you stabilise copd, then your decline is the same as a healthy person's, but just lower down the graph as we are starting out with a deficit. But from what you say above, logically our graph line would eventually meet the graph line of people with normal lung function - which would be fab! if of course we lived long enough :)

    Wouldnt a parallel line mean the lung damage must be healing, which ive always been told doesnt happen? i was always told that we can train our muscles to use O2 better and therefore exercise ability improves, but our FEV1 still stays much the same. But having said that, I started some mild intensity training earlier this year and mine did actually improve from 40% to 45% so . . . . .

    Plus there have been pilot projects in Kent where i live researching the benefits of singing for people with copd and they are finding that there has been some improvement there too.

    Everyone declines with age, and id have thought we'd be the last people to be exempt from that ;) but then again new research is happening all the time, more of us are sharing our experiences, and that can challenge orthodox medical opinion and give us more hope.

    If you have more info on this I'd love to hear it Stitch. Hope i havent gone on too long :) jean

  • So many factors and co-factors. maybe there will never be a definitive opinion. enjoy your evening Stitch :)

  • Hi Warren

    In people without lung diesease who don't smoke the rate of lung decline is around 30mls a year. If you don't smoke, and avoid where possible colds/respiratory infections, this should be similar for yourself

  • FEV1 is measured in litres. The FEV1 % is worked out comparing the actual figure in litres compared with similar values in people (same height, sex, age) without lung disease.

    There can be some slight variability in the FEV1 and FVC however in COPD it will never improve significantly as by definition it is chronic, airway obstruction with irreversible damage.

  • Will you confirm that you are a qualified respiratory nurse this will save confusion for the members reading this when the BLF has their own nurses here it has potential for mistakes thank you so much for your help with this.

  • Thank you for you answers so far. From my own reaseach i understand that people with copd have a lower fev1 % than someone without it. If your fev1 is at 65% and your lung function drops by 30ml each year how will that affect my fev1% in percentage terms ? Should i see a drop in my fev1% . This is what i am confused by how can fev1 stay the same if my lung function is decining by 30ml per year.

    Regards warren

  • The measurement in litres would go down by 30ml each year.

    But the percentage figure likely wouldnt, just because its a percentage of what is predicted for your age (and other factors) which will change year on year. So there's an adapted prediction of your FEV1 percentage each year. Throughout 7 years I was 40-41%, but the volume in litres was going down a little each year.

    Hope this helps. I like to understand it all too - what i still find very hard is the ratio between FEV1 and FVC. Its kinda endless once you start :) jean

  • I'm going with Douglas Adams on this topic - 42

  • Love it Mr. Hitchiker

  • Does the % lung function in millilitres show up on a spiromerty test ? Is that the FVC ? The FEV1 & FVC are the only two things i have a basic understanding of on a spitomerty test.

    FVC. Can predict the type of obstruction ie restrictive or obstructive but again im not sure how you interpret the results.

  • Hi stitch, from what i have read i agree with respnurse regarding copd lung function declincing at the same rate as a person without copd once smoking as been stopped in most cases age and stage when you stop obviously play a big part. I take spriva and this opens the airways i have had a spiromerty without taking it and my result have been worse so it must be doing something.

  • There is no set answer to this. One can talk in averages, or 'if this' and 'if that' but nothing is written in stone as far as COPD is concerned. As I have mentioned before, the latest findings are that roughly a third of us will stay pretty stable, a third decline slowly and a third more rapidly. All we can do is up our odds by not smoking, exercising and taking meds.

    Fev1 not only varies over the years, but even over the day. Very few people will blow the exact same 'number' two or three times when being tested - that is why we have 3 blows and the best of three is is classed as the result. Spirometry is an art as much as a science, and is dependent on the patient and time of day, as much as the nurse or the machine. A reading taken early morning as soon as you get up is likely to be quite a few points lower than it would be by mid morning - we all know that awful struggle to breathe when we first get up in the morning. Likewise an evening reading when we are tired will probably give a poorer result - our muscles are tired and feeble by then, including our respiratory muscles.

    Some patients don't blow as hard as they might do - this shows up on the graph curve as the curve is not the correct shape for COPD or anything else. This can confuse things and make it difficult to discern whether the patient has asthma or COPD. Likewise a different type of curve on the graph will suggest restrictive diseases such as IPF or Fibrosis.

    As for people who 'defy copd through exercise', they don't defy their COPD. They may or may not get a slightly improved reading because they have strengthened what was previously an overly weakened diaphragm or other deconditioned respiratory muscles (including abs). What they do get is greatly improved SOB and improved strength to fight off infection, as well as improved quality of life. The exercise gives more benefit than any copd drug yet invented. It would be more accurate to say that someone who doesn't exercise or stay active, someone who spends a lot of time siiting down, is likely to have a misleadingly lower fev1 than it would otherwise be, because of severe deconditioning. Likewise obesity - particularly around the abdomen - impacts on both fev1 and SOB. So someone who is more than a stone or so overweight will get lower readings than they would if they lost the belly fat.

    On rate of fev1 decline we can read different things in different journals, so in the Primary Care respiratory Journal I read that on average the rate of loss is 60ml/year - double that of non-COPD subjects. More recent studies show a much more mixed picture - the link should take you to a good article on this;

    pulmccm.org/main/2011/copd-...

  • Two points I had forgotten until I reread the above article - the study did show that 8% of participants did indeed have an increase in fev1 of more than20ml a year. It also mentions the authors view that COPD may 'burn out over time', so I guess there is hope for us all yet :)

  • Thank you Parvati for the link, have read it several times it appears that we are a complexed tapestry of patients whos lung function can vary between 30-60ml a year or stay the same or even improve....intresting reading regarding it burning itself out never read anything about that before.

    The study regarding smokers and copd seems to make sense in that none smokers lungs fully develop and thier lungs stays at that level for sometime before gradually declining where as smokers just start declining as soon as the lungs have fully developed (obviously due to the damage caused by smoking)

    I find this whole subject entralling, i just wish it didnt apply to me.

    Have a nice day

    Kind regards

    Warren

  • After reading this lot im now in need of a -

    Pan-Dimensional Gargle Blaster

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