COPD: GOLD Stages Explained

Despite it being a common and treatable disease, Chronic Obstructive Pulmonary Disease (COPD) tends to go undiagnosed or misdiagnosed, which then leads to inadequate treatment. It truly makes a difference to recognize COPD's links to factors beyond smoking, its potential early onset, and forerunner conditions in terms of enabling prevention and early intervention.
Today, we would like to inform you about the GOLD (Global Initiative for Chronic Obstructive Lung Disease) stages in COPD and discuss what these stages mean for the diagnosis and treatment. The categorization made within the GOLD stages is based on the severity of the disease, that is decided in terms of the level of airflow obstruction. The stages that are going to be to be briefly explained in the following are defined by the post-bronchodilator FEV1/FVC (forced expiratory volume in one second/forced vital capacity) ratio.
In the initial stage of COPD, namely GOLD 1, the functioning of the lung deviates by 0–20 percent from the target (norm) value. In line with these numbers, the difficulty in breathing is usually so mild that individuals barely notice the condition. Being one of the known COPD symptoms, chronic cough and sputum (mucus) production may occur.
In GOLD stage 2, which is representing itself as the moderate stage of COPD, the lung function deviates by 20–50 percent from the target value. It is expected that the individuals may experience mild shortness of breath during significant physical exertion at this stage. GOLD stage 3 is characterized by severe COPD, with the lung function deviating by 50–70 percent from the target value, understandably leading to significant breathing difficulties and possibly a persistent cough with thick sputum. These and other COPD symptoms tend to become more noticeable, even with light physical activity, such as climbing stairs.
In the end-stage, GOLD 4, one speaks of a lung function that deviates by more than 70 percent from the target value. This is where the patient has “severe COPD”. At this stage, the patients are not receiving an adequate or sufficient amount of oxygen, suffering from severe breathlessness during daily activities and sometimes even at rest. Hence, their physical capacity is greatly limited.
It cannot be stressed how important a diagnosis of COPD in a timely manner is, but one must also keep in mind that it involves quite a complex approach.
First of all, one should keep in mind that COPD is not the only chronic disease that manifests itself in breathing problems. In that regard, eliminating other respiratory conditions, or recognizing overlaps (such as Asthma and COPD overlap) marks one of the most important steps in the diagnosis process. Secondly, in case a breathing test shows a ratio between 0.60 and 0.80, it is advised to rather double-check for accuracy. If the ratio is below 0.6, this means that the condition is less likely to improve naturally. Although there is currently a debate about whether to use a fixed ratio or another measure called LLN (Lower Limit of Normal) for diagnosis, many healthcare workers seem to prefer the simplicity of the fixed ratio. Lastly, not everyone needs to be screened for COPD, but for those with symptoms or risks, a breathing test can be a valuable tool for early detection. In essence, diagnosing COPD is a nuanced process that involves considering various factors to ensure accuracy and appropriate care, in line with the indications of the GOLD stages.
Having gone over the meaning of the GOLD stages and made a few remarks on the importance of, and challenges in the diagnosis of COPD, we would now like to dedicate the last part to something that we think is going to interest you: The Breathment Therapy App that revolutionizes COPD therapy and management. Providing a remote way of COPD physiotherapy, Breathment aims to be a key in improving your quality of life, bringing the exercises, physiotherapists and educational content, all in your hands. Book an appointment with us now to learn how Breathment makes your life with COPD easier.