Symptomatic Undiagnosed COPD and Asthma: Disease Burden and Quality of Life

Mature adult man lying down on sofa in living room and using inhaler.He is wearing sleepwear
How do individuals with undiagnosed asthma and COPD manifest these conditions over time, and how do these undiagnosed conditions affect quality of life?

Canadian adults experiencing breathing problems often have undiagnosed chronic obstructive pulmonary disease (COPD) or asthma, which manifested as an increased burden of respiratory symptoms and worse health-related quality of life. These were among study findings published in Respiratory Medicine.

The effects of living with undiagnosed asthma or COPD — with respect to quality of life and mortality — is unknown. Investigators sought to examine the symptom burden, quality of life, and utilization of health care among individuals with self-reported respiratory issues that were subsequently identified as undiagnosed airflow obstruction. The researchers also compared these individuals with others who had self-reported respiratory symptoms but who were not deemed to have undiagnosed airflow obstruction.

The investigators conducted a retrospective, cross-sectional, case-finding study of 1660 Canadian adults with respiratory symptoms but no history of lung disease, analyzing patient data from the Undiagnosed COPD and Asthma Population (UCAP) study. Patients included in the study had been randomly recruited by telephone and subsequently assessed for asthma and COPD. The investigators analysis spirometry findings for 1615 participants and found that 20.5% had undiagnosed asthma or COPD.

Results of the St. George’s Respiratory Questionnaire (SGRQ) and the COPD Assessment Test (CAT) indicated that participants with undiagnosed asthma and COPD had more respiratory symptoms than individuals with no airflow obstruction. There were no between-group differences noted in health care utilization, or work or school absenteeism.

Study limitations included response bias resulting from self-reporting and likely underestimation of between-group differences due to the limited testing performed on control group participants.

Researchers concluded that, “Undiagnosed asthma and COPD are common in Canadian adults experiencing breathing problems and are associated with a greater burden of symptoms and poorer health-related quality of life.” They added that their results suggest early detection and treatment of “undiagnosed asthma and COPD,” may prove beneficial to patients.


Alhabeeb FF, Whitmore GA, Vandemheen KL, et al. Disease burden in individuals with symptomatic undiagnosed asthma or COPD. Respir Med. Published online July 3, 2022. doi:10.1016/j.rmed.2022.106917